TY - JOUR
TI - Comparison of the smoothness index, the trough: peak ratio and the
morning: evening ratio in assessing the features of the anti
hypertensive drug effect
AU - Stergiou, GS
AU - Efstathiou, SP
AU - Skeva, II
AU - Baibas, NM and
AU - Roussias, LG
AU - Mountokalakis, TD
JO - JOURNAL OF HYPERTENSION
PY - 2003
VL - 21
TODO - 5
SP - 913-920
PB - Lippincott, Williams & Wilkins
SN - -
TODO - 10.1097/00004872-200305000-00015
TODO - ambulatory blood pressure; antihypertensive drugs; home blood pressure;
morning : evening ratio; smoothness index; trough : peak ratio
TODO - Objective To provide a direct comparison of the trough: peak ratio
(TPR), the morning: evening home blood pressure ratio (MER) and the
smoothness index (SI) in assessing the features of the anti hypertensive
drug effect.
Patients and methods A total of 27 untreated hypertensives were
randomized to receive lisinopril 20 mg o.d. or losartan 50 mg o.d. for 5
weeks and were subsequently crossed-over to the alternative treatment
for a second 5-week period. Twenty-four hour ambulatory and 5-day home
blood pressure were monitored before randomization and at the end of
each treatment period. TPR, MER and SI were calculated for each drug for
the total study population and for responders only.
Results When all patients were considered, lisinopril provided higher
values of TPR [0.63/0.66 for systolic/ diastolic blood pressure
(SBP/DBP)], MER (1.02/0.77) and SI (1.01/0.87) than losartan (0.35/0.51,
0.60/0.60 and 0.64/ 0.53, respectively). Analysis of responders only,
again showed a clear advantage of lisinopril over losartan in TPR
(0.77/0.67 versus 0.44/0.47, respectively) and MER (0.86/ 0.87 versus
0.48/0.61), whereas there was no difference in SI (1.25/1.13 for
lisinopril versus 1.11/1.12 for losartan).
Conclusions These data suggest that the assessment of the duration of
the anti hypertensive drug effect provided by the M ER is consistent to
that by the TPR and that two drugs with different levels of TPR and MER
may have the same level of SI. It appears that the SI is not simply a
more reliable index of the features of the anti hypertensive drug effect
but offers a different type of information complementary to that
provided by the TPR and the MER, in regard to the homogeneity and the
magnitude but not the duration of the anti hypertensive effect. (C) 2003
Lippincott Williams Wilkins.
ER -