Effects of antihypertensive drugs on SBP variability are dose-dependent and persist when used in combinations .
Use of a high dose of a calcium channel blocker alone or in combination with other agents is therefore likely to be particularly effective in prevention of stroke
BACKGROUND AND PURPOSE Recent studies have shown that visit-to-visit blood pressure variability is a powerful risk factor for stroke , is reduced by calcium channel blockers and diuretics , and increased by β-blockers .
However , it is unknown whether these effects are dose-dependent and persist in combination with other drugs .
Comparative effects of amlodipine monotherapy and combination therapy with betaxolol on cardiac autonomic nervous activity and health-related quality of life in patients with poorly controlled hypertension.
BACKGROUND The aim of the study was to evaluate whether the combined treatment of calcium channel blocker , amlodipine and beta-blocker , betaxolol , favorably affects cardiac autonomic nervous activity ( CANA ) and health-related quality of life ( HRQL ) . METHODS AND RESULTS A total of 65 patients with a poor blood pressure ( BP ) control with a low dose amlodipine therapy were r and omly assigned to the amlodipine dose-up group ( n=21 ) and betaxolol adding group ( n=44 ) . Before and after a 6-month treatment , BP , heart rate variability ( HRV ) , HRQL and blood chemistries were evaluated . Low frequency ( LF ) spectra/high frequency ( HF ) spectra and HF/total power spectra ( TP ) were calculated as indexes of CANA , and HRQL was assessed by the question naire sheets . BP was well controlled in all patients of the present study . In the betaxolol adding group , LF/HF decreased ( 2.1+/-1.9 to 1.3+/-0.9 , p<0.05 ) and HF/TP reciprocally increased ( 0.41+/-0.17 to 0.52+/-0.18 , p<0.05 ) , whereas the amlodipine dose-up group showed no significant changes in the HRV . HRQL was significantly improved in the betaxolol adding group , whereas it remained unchanged in the amlodipine dose-up group . Blood chemistries remained unchanged except for the slightly increased plasma brain natriuretic peptide concentrations in the betaxolol adding group ( 36+/-47 to 62+/-62 pg/ml , p<0.05 ) . CONCLUSIONS Combined treatment of amlodipine and betaxolol appears to be more useful than amlodipine dose-up therapy , because combined treatment improves CANA and HRQL
Effects of antihypertensive drugs on SBP variability are dose-dependent and persist when used in combinations .
Use of a high dose of a calcium channel blocker alone or in combination with other agents is therefore likely to be particularly effective in prevention of stroke
BACKGROUND AND PURPOSE Recent studies have shown that visit-to-visit blood pressure variability is a powerful risk factor for stroke , is reduced by calcium channel blockers and diuretics , and increased by β-blockers .
However , it is unknown whether these effects are dose-dependent and persist in combination with other drugs .