Efficacy of once-daily lisinopril monotherapy in systemic hypertension

Lisinopril is a new, long-acting angiotensin-converting enzyme inhibitor formulated for once-daily treatment of hypertension. This study assessed the 24-h efficacy and tolerability of lisinopril in Chinese patients with mild to moderate hypertension of World Health Organization Stages I to II. A total of 30 patients aged 30 to 60 years (mean 47 +/- 9) entered a 2-week washout period. All patients had ambulatory diastolic blood pressure (BP) > 90 mmHg and were given active treatment with lisinopril for 4 to 7 weeks. The dose of lisinopril was titrated from 10 to 40 mg daily (at 8-9 A.M.). In each patient, 24-h ambulatory blood pressure (BP) monitoring (SpaceLabs 90202) was performed twice, once before and once following treatment. Mean 24-hour systolic/diastolic BPs after lisinopril were significantly decreased compared with baseline values (132 +/- 12/86 +/- 7 vs. 150 +/- 11/98 +/- 7 mmHg; p < 0.0005/0.0005). The average dose of lisinopril was 14.5 +/- 5 mg daily after a titration period of 5 weeks of treatment. Mean daytime (6 A.M. to 6 P.M.) BP decreased from 152 +/- 11/100 +/- 8 to 134 +/- 12/87 +/- 8 mmHg (p < 0.0005/0.0005) and nighttime (6 P.M. to 6 A.M.) BP from 147 +/- 14/95 +/- 9 to 128 +/- 14/83 +/- 8 mmHg (p < 0.0005/0.0005). BP reduction was more pronounced during the night. Before treatment, the circadian variation showed a peak BP at 11 A.M. and nadir at 3 P.M. After treatment, significant BP reduction (p < 0.0005/0.0005) was seen throughout the 24-h period.(ABSTRACT TRUNCATED AT 250 WORDS)