[Evaluation of efficacy of the enalapril-hydrochlorothiazide combination by ambulatory blood pressure monitoring in essential hypertensive patients]. / Avaliação da eficácia da associação enalapril-hidroclorotiazida através da monitorização ambulatorial da pressão arterial em hipertensos essenciais.

ABSTRACT

PURPOSE: Evaluation the 24 hours efficacy of once daily enalapril plus hydrochlorothiazide association by ambulatory blood pressure monitoring. METHODS: Thirty-nine essential hypertensive patients (3 male, 36 female; 31 white, 8 non-white; mean age 46,7 years old) with the criteria, after wash-out period, of more than 40% of diurnal diastolic blood pressure measurements above 90mmHg by ambulatory blood pressure monitoring, were allocated for treatment during 8 weeks with once daily administration of enalapril (20mg) plus hydrochlorothiazide (12.5mg) association. RESULTS: After wash-out period, 82 and 42%, respectively, diurnal and nocturnal systolic blood pressure measurements were above 140mmHG; while diastolic values were 79 and 26% above 90mmHg. After 8 weeks of treatment there was a significant reduction in both systolic and diastolic pressure loads, either on nocturnal or diurnal periods; 26 and 5.3% of systolic values were still above 140mmHg and, 31.5 and 7.9% of diastolic measurements were above 90mmHg. Despite the significant fall on blood pressure there was not alteration in heart rate. CONCLUSION: The association of the angiotensin converting enzyme inhibitor, enalapril, plus a diuretic, hydrochlorothiazide, promoted a significant reduction on pressure load and did not interfere with the circadian rhythm of 24 hours blood pressure. These results may indicate that the association as suitable as one of the first choices for treating mild and moderate hypertensive patients.