Lisinopril: dose‐peak effect relationship in essential hypertension.

Abstract

3 Lisinopril 10 and 20 mg day-' produced similar peak antihypertensive effects which were greater than that produced by 2.5 mg day-1, but less than that of 80 mg day-'. If the incidence of first-dose symptomatic hypotension is related to the peak effect, then an initial lisinopril dose of 20 mg should not pose any greater risk than a 10 mg dose. 4 The magnitude of antihypertensive response at 24 h postdrug appeared to be dose related across the 2.5 to 80 mg day-' range.

Trough to peak ratio of once-daily lisinopril and twice-daily captopril in patients with essential hypertension

“…However, office BP at the end of the treatment periods was lower, and the percentages of patients controlled according to the conventional criteria (office BP Ͻ140/90 mm Hg) and responders according the ABPM criteria were higher with lisinopril than with captopril. The results for lisinopril were similar to those reported by other investigators 6 and can be explained by the high trough effect of the dose of 20 mg of lisinopril 7 even administered once-a-day in comparison with 50 mg captopril after 12 h.…”

Lisinopril versus enalapril: evaluation of trough:peak ratio by ambulatory blood pressure monitoring

“…Staessen et al 15 found similar timing of the peak effect with ABPM in patients using lisinopril and the time-topeak varied considerably in this population. In contrast, Cirillo et al, 32 using hourly office BP measurements up till 8 h after drug intake of 2.5-80 mg lisinopril, reported a dose-independent time-to-peak of 4 -5 h. By not using 24-h ABPM, the real peak effect may have been missed. For enalapril, others report a peak effect within 8 h. 9,27 Thus, in most of our patients office BP was taken before the maximum BP-lowering effect was reached, after which the dose was adjusted.…”

Optimal dose of lisinopril for renoprotection in type 1 diabetic patients with diabetic nephropathy: a randomised crossover trial

“…Previous dose titration studies with lisinopril have been conducted in (1) non-diabetic patients with essential hypertension, using BP reductions as the main outcome [2,3]; and (2) patients with non-diabetic nephropathies [9,10]. Lisinopril 40 mg was shown to lower albuminuria and BP more effectively than lisinopril 20 mg. Higher doses have only been tested in essential hypertension studies.…”

“…Dose titration studies of ACEIs are traditionally conducted according to BP levels in essential hypertension [2,3]. The optimal BP-lowering dose is not, however, necessarily the same as the optimal dose for renoprotection.…”