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ACE-inhibitor therapy with spirapril increases nocturnal hypotensive episodes in elderly hypertensive patients

Journal of Human Hypertension volume 15, pages 873–878 (2001)Cite this article

Abstract

The purpose of this double-blind, randomised trial with a 4-week placebo run-in period followed by an active treatment period using either spirapril 3 mg or 6 mg once a day was to clarify the existence of hypotensive episodes in elderly hypertensive patients treated by an ACE-inhibitor. Forty hypertensive patients aged 60–76 years underwent 24-h ABPM at the end of the run-in (week 4) and active treatment (week 9) periods. The mean 24-h systolic blood pressure (SBP) decreased from 161.9 (26.7) mm Hg to 150.6 (29.9) mm Hg (P < 0.001) and diastolic blood pressure (DBP) from 91.70 (14.7) mm Hg to 84.2 (17.3) mm Hg (P < 0.001). No episodes of mean arterial pressure (MAP) <50 mm Hg were seen during the placebo period. Instead 11 episodes were observed during the antihypertensive treatment (one in the 3 mg group and 10 in the 6 mg group, P < 0.01 between the two treatment groups). Fifty-four episodes of MAP <70 mm Hg were observed during the placebo period and 117 during the treatment period (P < 0.001). During the placebo period low MAPs were observed only during night time. During the treatment period they were seen also from 11 am to 4 pm. In conclusion, ACE-inhibitor therapy with spirapril significantly increased hypotensive episodes in elderly hypertensive patients which may worsen their cerebral and myocardial circulation

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Acknowledgements

This study was supported by Novartis Ltd, Basel, Switzerland and Novartis Finland, Espoo, Finland.

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Authors and Affiliations

  1. Department of Medicine, Turku University Central Hospital, Turku, Finland

    I Kantola

  2. Department of Medicine, Uppsala University Hospital, Uppsala, Sweden

    A Terént

  3. National Public Health Institute, Helsinki, Finland

    M Kataja

  4. Department of Medicine, Söderhamn Hospital, Söderhamn, Sweden

    E Breig-Åsberg

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  1. I Kantola
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  2. A Terént
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  4. E Breig-Åsberg
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Correspondence to I Kantola.

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Kantola, I., Terént, A., Kataja, M. et al. ACE-inhibitor therapy with spirapril increases nocturnal hypotensive episodes in elderly hypertensive patients. J Hum Hypertens 15, 873–878 (2001). https://doi.org/10.1038/sj.jhh.1001285

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  • DOI: https://doi.org/10.1038/sj.jhh.1001285

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