Aims: To assess the persistence of the antihypertensive effect of the ACE-inhibitor perindopril after one missed dose.
Methods: After a placebo run-in period, 10 hypertensive patients were started on perindopril 4 mg once daily in the morning, increased to 8 mg once daily after 4 weeks if office diastolic BP >85 mmHg. 24 h BP monitoring was performed at the end of the placebo run-in period and during active treatment in week 9 and 10 on either active treatment or a placebo-day using a double-blind, randomized, cross-over design.
Results: Office BP decreased from 155+/-3/100+/-2 mmHg at the end of placebo to 139+/-3/89+/-2 mmHg (P<0.05 vs placebo) after 8 weeks of active treatment. After 2 months of active treatment, 24 h ABP showed significant decreases in day BP by -11+/-1/-7+/-1 mmHg and in night BP by -11+/-2/-7+/-1 mmHg while on active treatment. During the placebo-day, daytime BP showed decreases by -10+/-1/-5+/-1 and night BP by -8+/-2/-6+/-1 mmHg (NS vs active treatment day).
Conclusions: Perindopril 4-8 mg day-1 causes a persistent decrease in BP during the 24 h dosing interval, which is mostly maintained over the 24-48 h after dosing.