+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

How relevant is the trough-to peak ratio?



How relevant is the trough-to peak ratio?



Schweizerische Medizinische Wochenschrift 130(9): 329-335



A marked blood pressure rise in the early morning hours is associated with an increased prevalence of cardiovascular events. Moreover, it has been reported that the blood pressure fall during the night is inversely correlated with left ventricular mass, peripheral vascular resistance and cerebrovascular insults. Recently, assessment of the so called "trough-to-peak ratio" has been increasingly used in order to evaluate the duration of action of antihypertensive agents. In this review some aspects of this arithmetical index are highlighted, and specifically the fact that this ratio as a surrogate endpoint may in some circumstances influence the choice of an antihypertensive agent but nevertheless does not serve to predict the clinical efficacy of blood pressure lowering drugs. To date the trough-to-peak ratio remains a problematic parameter because of the lack of defined optimal values and the lack of general and standardised methods for its determination. It is thus a purely arithmetical index without major clinical relevance. Evaluation of the clinical efficacy of antihypertensive drugs should rather be based on 24-hour measurements, as a more reproducible parameter.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 046280943

Download citation: RISBibTeXText

PMID: 10746273


Related references

Trough-to-peak ratio, smoothness index and morning-to-evening ratio: why, which and when?. Journal of Hypertension 21(5): 851-854, 2003

Comparison of the smoothness index, the trough : peak ratio and the morning : evening ratio in assessing the features of the antihypertensive drug effect. Journal of Hypertension 21(5): 913-920, 2003

The trough/peak ratio. Annali Italiani di Medicina Interna 10 Suppl: 91s-95s, 1995

Trough to peak ratio: time for reappraisal?. Journal of Human Hypertension 12(1): 35-36, 1998

Clinical implications of trough to peak ratio. Nihon Rinsho. Japanese Journal of Clinical Medicine 58(Suppl. 2): 224-227, 2000

Evaluation of high trough-to-peak ratio of perindopril in SHR. Clinical & Experimental Hypertension 21(7): 1223-1238, 1999

Trough: peak ratio: clinically useful or practically irrelevant?. Journal of Hypertension 13(3): 279-283, 1995

The trough-to-peak ratio in the evaluation of an antihypertensive drug. Giornale Italiano di Cardiologia 24(8): 1043-1048, 1994

Is trough:peak ratio a guide to clinical efficacy?. International Journal of Clinical Practice 53(4): 240 250, 1999

Trough to peak ratio: current status and applicability. Journal of Human Hypertension 12(1): 55-59, 1998

Does the trough/peak ratio of the ACE inhibitors comply with the FDA recommendations?. European Heart Journal 14(ABSTR Suppl. ): 65, 1993

Methodological considerations in calculation of the trough: peak ratio. Journal of Hypertension. Suppl. 12(8): S3-6; Discussion S6-7, 1994

Problems in the evaluation of antihypertensive therapy using the trough/peak ratio. Cardiovascular Drugs & Therapy 11(3): 459-463, 1997

Relevance of the trough-to-peak ratio to the 24 h blood pressure load. American Journal of Hypertension 9(10 Part 2): 91S-96S, 1996

Antihypertensive treatment and trough: peak ratio: general considerations. Journal of Hypertension. Suppl. 12(8): S79-82; Discussion S83, 1994