PRISMA I and II
Background/Rationale: The early morning hours usually coincide with a sharp rise in blood pressure (BP) and a high incidence of cerebro- and cardiovascular events, such as sudden death, myocardial infarction and stroke.
Objective: PRISMA I and II are sister studies conducted to compare the efficacy and safety of once-daily use of Pritor®/Kinzalmono® (telmisartan) and ramipril on blood pressure reductions during the last 6 hours of the dosing interval Using ambulatory blood pressure monitoring (ABPM).
Study Design: PRISMA I and II were 14-week prospective, randomised, open-label, blinded-endpoint (PROBE), multicentre, parallel-group, forced titration studies in patients with mild to moderate hypertension.
Study Endpoints:
- Primary endpoint: reductions from baseline in SBP and DBP during the last 6 hours of the dosing interval using using ambulatory blood pressure monitoring (ABPM).
- Secondary endpoint: changes in 24-hour, morning, daytime and night-time mean ambulatory BP and ambulatory BP response rates.
Results: Pritor®/Kinzalmono® provided significantly greater systolic and diastolic blood pressure reductions (SBP and DBP) in the last 6 hours of the dosing interval compared with ramipril at week 14.
Williams B et al. PRISMA II. Hypertension. 2006;24:193-200.
Lacourcière Y et al. PRISMA II. AJH. 2006;19:104-112.
Lacourcière Y et al. PRISMA II. AJH. 2006;19:104-112.
Conclusion:
- Pritor®/Kinzalmono® has a longer half life than ramipril
- Pritor ®/Kinzalmono® with its longer duration of effect was significantly more effective than ramipril in reducing blood pressure:
- Throughout the 24-hour dosing interval
- During the last 6 hours, a time when patients appear to be at greatest risk of cerebro- and cardiovascular events.
- Throughout the 24-hour dosing interval
- Compared with ramipril, Pritor®/Kinzalmono® significantly reduces early morning blood pressure, a time when patients appear to be at greatest risk for cerebro- and cardiovascular events.
