A smooth blood pressure control is obtained over 24 h by delapril in mild to moderate essential hypertensives

Objective: To assess the homogeneity of the antihypertensive effect of delapril over 24 h. Design and methods: After 2 weeks of placebo 50 mild to moderate essential hypertensives (age 54 +/- 5 years) were subjected to 8 weeks of treatment with delapril 30 mg once daily. At the end of each period, blood pressure (BP) was assessed by conventional sphygmomanometry (clinic or CBP) and ambulatory (A) BP monitoring. Twenty-four-hour means, trough-to-peak ratio (T/P) and smoothness index (SI, the ratio between the average of the 24-h BP changes after T and its standard deviation) were calculated for systolic (S) and diastolic (D) BP. Results: CBP and ABP were significantly reduced by treatment. Pulse pressure (PP, the SBP-DBP difference) was also significantly (p < 0.01) reduced by delapril (5.7 +/- 6.2 and 3.3 +/- 3.8 mmHg, CPP and APP). The median T/P was higher (0.51 and 0.62, SBP and DBP) in the 43 responders at trough than in the whole group (0.44 and 0.51). The SI was similarly high in the whole group (1.3 +/- 0.6 and 1.4 +/- 0.6, SBP and DBP) and in the responders (1.4 +/- 0.5 and 1.5 +/- 0.6). Conclusions: Delapril effectively and smoothly reduces BP over 24 h, this effect being evident also on PP, a parameter with a relevant prognostic value