Once-daily dihydropyridine calcium channel blockers appeared to lower blood pressure by a relatively constant amount throughout the 24-hour dosing interval .
Six dihydropyridine calcium channel blockers studied in this review lowered blood pressure by a relatively similar amount each hour over the course of 24 hours .
BACKGROUND Calcium channel blockers are a heterogeneous class of drugs , including dihydropyridine and non-dihydropyridine subgroups , commonly used in the treatment of hypertension .
A systematic review of the 24-hour time course of the blood pressure-lowering effect has not been published .
OBJECTIVES To assess how much variation there is in hourly systolic and diastolic blood pressure lowering by dihydropyridine calcium channel blockers over a 24-hour period in people with hypertension aged 18 years or over , with baseline systolic blood pressure of at least 140 mmHg or diastolic blood pressure of at least 90 mmHg , or both .
Use of 24-h ambulatory blood pressure monitoring to assess blood pressure control: a comparison of olmesartan medoxomil and amlodipine besylate
Objective Olmesartan medoxomil is an angiotensin II receptor blocker with similar antihypertensive efficacy as the calcium channel blocker amlodipine besylate in patients with mild-to-moderate hypertension . In addition to a drug 's ability to lower blood pressure , the effectiveness of the agent in enabling patients to achieve specific blood pressure targets is an important clinical consideration . This secondary analysis of a r and omized , double-blind study compared the efficacy of olmesartan medoxomil with that of amlodipine besylate in achieving ambulatory blood pressure goals among patients with mild-to-moderate hypertension . Methods Following a 4-week placebo run-in , 440 study participants aged ≥18 years were r and omized to olmesartan medoxomil ( 20 mg/day ) , amlodipine besylate ( 5 mg/day ) , or placebo for 8 weeks . The proportion of participants achieving specific systolic and diastolic ambulatory blood pressure goal levels was calculated by dividing the number of participants who had achieved a particular blood pressure goal by the total number of patients in the intent-to-treat population . Results After 8 weeks of treatment , a mean 24-h ambulatory blood pressure of < 130/80 or < 130/85 mmHg was achieved by significantly more participants in the olmesartan medoxomil group ( 18.1 and 30.4 % , respectively ) than in the amlodipine besylate ( 7.0 and 14.0 % , respectively ) or placebo ( 1.9 % for both ) groups . The target daytime ambulatory blood pressure of < 135/85 mmHg was achieved by more participants in the olmesartan medoxomil group than in the amlodipine besylate group ( 15.8 vs. 5.8 % , respectively ; P<0.01 ) . Conclusion In a previous publication of the same study , we demonstrated that starting doses of olmesartan medoxomil and amlodipine besylate produced similar mean reductions in blood pressure . In this sub analysis of the blood pressure data from that primary publication , however , olmesartan medoxomil therapy was shown to result in a greater proportion of patients achieving specific ambulatory blood pressure goals than therapy with amlodipine besylate . As blood pressure goal attainment may be of more direct clinical relevance than numerical blood pressure lowering , the achievement of blood pressure goals should be a key efficacy parameter assessed in clinical trials of antihypertensive medications
Once-daily dihydropyridine calcium channel blockers appeared to lower blood pressure by a relatively constant amount throughout the 24-hour dosing interval .
Six dihydropyridine calcium channel blockers studied in this review lowered blood pressure by a relatively similar amount each hour over the course of 24 hours .
BACKGROUND Calcium channel blockers are a heterogeneous class of drugs , including dihydropyridine and non-dihydropyridine subgroups , commonly used in the treatment of hypertension .
A systematic review of the 24-hour time course of the blood pressure-lowering effect has not been published .
OBJECTIVES To assess how much variation there is in hourly systolic and diastolic blood pressure lowering by dihydropyridine calcium channel blockers over a 24-hour period in people with hypertension aged 18 years or over , with baseline systolic blood pressure of at least 140 mmHg or diastolic blood pressure of at least 90 mmHg , or both .