Effects on 24-hour blood pressure variability of ace-inhibition and calcium channel blockade as monotherapy or in combination.
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Cardiovascular events in hypertensives are associated with elevated average blood pressure BP and higher short term BP variability V but little is known on treatment effects on BPV and on how to assess changes in short term BPV Aim of our study was to address the methodology of short term BPV assessment and its reduction by Lercanidipine L or Enalapril E and their combination through analysis of 24 hour ambulatory BP recordings from two studies including subjects of different age Study 1 64 middle age hypertensives 52 9 9 5 yrs received L and E s i d at 10 mg L10 E10 or 20 mg doses L20 E20 for 8 weeks Study 2 66 elderly hypertensives 65 5 4 7 yrs received placebo L10 E20 and L10 E20 s i d for 4 weeks In middle age subjects both L and E decreased mean BP and at the highest dose also short term BPV In elderly subjects L10 alone or in combination with E20 reduced BPV Treatment induced reductions in BP levels and BPV were uncorrelated Different methods for short term BPV assessment did not always provide superimposable results in the elderly Our study supports a better reduction of BPV by L in the elderly and by E L combination at any age suggesting BPV reduction to be independent from reduction in average BP