Evening vs morning isradipine sustained release in essential hypertension: a double‐blind study with 24 h ambulatory monitoring.

Abstract

A randomized, double‐blind, placebo controlled study evaluated the effects on 24 h ambulatory blood pressure (ABP) of isradipine sustained release (I‐SRO) administered once daily, in the morning (AM) or in the evening (PM). Eighteen uncomplicated essential hypertensives (10 men, mean age 55 +/‐ 6 years) with casual sitting DBP 96‐110 mm Hg received, according to a triple‐way crossover design, I‐SRO 5 mg AM, or 5 mg PM, or placebo for 4 weeks. A 24 h ABP monitoring (Spacelabs 90207) was carried out at the end of each treatment. Twenty‐four hour BP was 145.3/89.8 mm Hg after randomized placebo. AM and PM I‐SRO significantly reduced 24 h BP, by 13.7/8.7 and 12.9/8.2 mm Hg respectively. Daytime (07.00 h‐23.00 h) BP significantly decreased by 15.0/9.7 mm Hg with AM and 13.2/8.7 mm Hg with PM regimen; night‐time BP (23.00 h‐07.00 h) significantly decreased by 11.6/7.1 and 12.3/7.4 mm Hg, respectively. Nocturnal nadir BP values were 132.6/78.1 after randomized placebo, 120.9/71.4 after AM I‐SRO and 121.0/72.4 mm Hg after PM I‐SRO. Morning peak BP values were 154.6/96.9, 139.5/87.6 and 137.5/85.5 mm Hg, respectively. Mean BP values in the early morning hours (i.e. between 03.00 h and 08.00 h) were significantly decreased by 12.1/7.3 mm Hg after AM and 14.3/7.9 mm Hg after PM intake. No significant differences were detected in the BP lowering effect of the two I‐SRO regimens.(ABSTRACT TRUNCATED AT 250 WORDS) Copyright © 1993, Wiley Blackwell. All rights reserved