Treatment of hypertension: Favourable effect of the twice-daily compared to the once-daily (Evening) administration of perindopril and losartan

Ipoly Szauder, Eszter Csajági, Zsuzsanna Major, Gabor Pavlik, Gabriella Ujhelyi

Research output: Contribution to journalArticle

5 Citations (Scopus)


Background/Aims: Little is known about the effect of twice daily administration of same dose of ACE inhibitor and ARB on the diurnal/nocturnal blood pressure (BP) ratio. We aimed to assess the effect of two widely used long-acting drugs: perindopril and losartan in the treatment of hypertension comparing the once-daily (evening) vs. twice-daily (morning and evening) administration with the same daily doses. Methods: Untreated primary hypertensive patients without complaints (a total of 164: 65 men, 99 women, 55.7±13.7 years of age, 41-41 patients per treated groups) were selected with non-dipper phenomenon, estimated by diurnal index (DI) <10%. The effect of evening (8 mg perindopril or 100 mg losartan) vs morning and evening (4-4 mg perindopril or 50-50 mg losartan) administration was determined on a 14- day treatment by ABPM. Results: The mean BP, the percent time elevation index, and the hyperbaric impact decreased in both drug groups. Significant difference was observed in the DI in the case of twice-daily administration vs once-daily evening dosing. Conclusions: The twice-daily administration with the same daily dose of perindopril or losartan seems to be more effective compared to the once daily evening administration in eliminating the nondipper phenomenon. According to some authors the non-dipping phenomenon increases cardiovascular risk, while others are of the opinion that the association of non-dipping with cardiovascular events does not necessarily mean that selective treatment of non-dipping improves cardiovascular outcomes.

Original languageEnglish
Pages (from-to)374-385
Number of pages12
JournalKidney and Blood Pressure Research
Issue number4
Publication statusPublished - Aug 20 2015


  • Circadian rhythm
  • Losartan
  • Non-dipper phenomenon
  • Perindopril
  • Treatment of hypertension

ASJC Scopus subject areas

  • Nephrology
  • Cardiology and Cardiovascular Medicine

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