Faiez Zannad, Agnes Matzinger și Jerome Larche **
** Prirmit pe 11 ianuarie 1995; acceptat pe 21 noiembrie 1995. De la Departamentul de Farmacologie Clinică şi Cardiologie, Universitatea Henri Poincare, Clinica Universitară Nancy, Franţa
Abstract
The once a day administration of the antihypertensive drugs can increase the compliance to the treatment if the drugs have a prolonged duration of action. The time/effect aspects for the antihypertensive drugs (medication) may not be wholy dependent of the plasmatic levels of the drugs. Therefore, we should measure the effects of the T/P report on the values of the blood-pressure (B.P.). We suggest that the “T/P” report has to be bigger than 50% for an optimal control of the BP 24 hour/day. Because of the lack of information in the litterature about T/P report for many of the C.E.I. and for the calcium antagonists and because we are in expectation for other comparative prospective studies with appropriate methodology, we have analysed the duration of decreasig action of B.P. duhring the long therm therapy with C.E.I. and calcium antagonists available (in drug-stores) in which there have been used the ambulatory survey of the B.P. There have been selected a number of studies with comparable methods over 24 species of C.E.I. and 34 calcium antagonists. The main T/P reports were calculated after remake of the amplitude modifies B.P. curve. The results shown that once a day administration of C.E.I. produced a bigger value over 50% of the T/P for fosinopril (64%), ramipril (50 – 63%) and trandolapril (50 – 100%). Other studies of C.E. indicated equal reports (T/P = 50%) enalapril 40 – 64%, cilazapril 10 – 80%, lisinopril 30 – 70%, or lower than 50% captopril 25%, benazepril 40%, perindopril 35%, quinapril 10 – 40% and moexipril 0 – 9%. The once a day administration of the calcium channels antagonists amlodipină 50 – 100%, lacidepină (40 – 100%), nifedipină Coat Core (50 – 69%), nifedipină, gastrointestinal system (GTTS) 60 – 94%) so as long therm liberation formula of diltiazem (20 – 80%) and verapamil (45 – 100%) have a T/P report bigger than 50% mean with Felodipin ER (30 – 45%) and other drug long therm liberation formula such as isradipin (10 – 80%), nitrendipin (10 – 80%) had T/P lower than 50%. Even if the retrospective analysis from litterature could have theoretical limits, they suggest that not all of C.E.I.
and C.A. with once a day administration may produce a “T/P” report bigger than 50%. This conclusion may have clinical implications.