Cor Vasa 2011, 53(10):547-551 | DOI: 10.33678/cor.2011.135

Tanatril Prague BP Project

Jiří Krupička^1,*, Jiří Widimský jr.², Karel Chroust³

¹ Kardiologická ambulance, Brandýs nad Labem, Česká republika

² III. interní klinika, Všeobecná fakultní nemocnice a 1. lékařská fakulta Univerzity Karlovy, Praha

³ Institut biostatistiky a analýz, Lékařská a Přírodovědecká fakulta, Masarykova univerzita, Brno

Introduction: Treatment with long-acting antihypertensive medication prevents the blood pressure elevation in morning hours, thus decreasing the cardiovascular risk. We used ABPM to assess the effect of imidapril on 24-hour blood pressure control in a 10-week trial.

Materials and methods: 412 patients (52% men) aged > 18 years (21-89; mean: 58; median: 60) with mild to moderate hypertension were enrolled. Imidapril monotherapy was used in 302 patients (73%) (de novo treatment or switch from another), 65 patients (16%) received combination of imidapril with another antihypertensive drug and not enough data for assessment were available from 45 patients (11%). During 10 weeks, 3 follow-up visits with 2 ABPMs took place (second visit-conclusion). The data were obtained using a standardized form and the blood pressure including ABPM was monitored in a standard way according to the guidelines. The mean imidapril dose was 11 mg daily.

Results: Mean baseline blood pressure was 155/92 mmHg (median: 155/92) and it dropped to 132/80 mmHg by 8 weeks of treatment (median: 130/80 mmHg; p < 0.001 for both BP values). In newly diagnosed hypertonics, the blood pressure dropped from 153/92 mmHg (median: 155/90) to 132/81 mmHg (median: 130/80) (p < 0.001 for both values). In patients switched to imidapril from another antihypertensive medication, the blood pressure decreased from 155/92 mmHg (median: 155/95) to 134/79 mmHg (median: 135/80) (p < 0.001 for both values). Previously treated hypertonics showed blood pressure decrease from 161/95 mmHg (median: 160/95) to 131/78 mmHg (median: 130/80) (p < 0.001 for both values). Mean 24-hour blood pressure dropped from 141/83 to 127/76 (p < 0.001 for all measurements). As for the group treated with monotherapy (newly diagnosed patients or switch), the mean values also decreased significantly to those recommended for ABPM (from 138/82 to 126/76 and from 142/83 to 128/76 mm Hg, respectively; p < 0.001 for all measurements) and the same significance level (p < 0.001) was observed for the changes of the daytime/nighttime mean values. In previously treated patients, the 24-hour mean value dropped from 145/84 to 128/75 mm Hg (p < 0.001 for both values). The treatment was withdrawn in 6 patients (1.5% of the entire population), all of which were treated with monotherapy. Dry cough was the reason for treatment withdrawal in half of them (0.8% of the entire population).

Conclusion: Treatment with imidapril - mean dose 11 mg once daily - lead to a very good 24-hour blood pressure control. This applied both to monotherapy (de novo treatment or switch from another) and to combinations with other antihypertensive medications. Dry irritative cough was observed in less than 1% of cases, confirming the low rates of this side effect described in other reports.

Keywords: Hypertension; Ambulatory blood pressure monitoring; 24-hour control of hypertension; Long-acting medications

Published: October 1, 2011  Show citation