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 .
A comparison of the efficacies and duration of action of the angiotensin II receptor blockers telmisartan and amlodipine.
OBJECTIVES : To compare the antihypertensive effects and duration of action of the angiotensin II receptor antagonist , telmisartan , amlodipine , and placebo in patients with mild-to-moderate hypertension using both conventional clinic blood pressures and ambulatory blood pressure monitoring ( ABPM ) . METHODS : After a 4-week single-blind , placebo run-in period , qualifying patients were r and omly allocated in double-blind manner to be administered 40 mg telmisartan ( n = 73 ; increased to 80 and 120 mg as necessary for patients whose diastolic blood pressure ( DBP ) remained > 90 mmHg ) ; 5 mg amlodipine ( n = 78 ; titrated to 5 mg and titrated to 10 mg for patients whose DBP remained > 90 mmHg ) ; or placebo ( n = 81 ) . ABPM was performed at the end of the baseline period and again at the end of 12 weeks of double-blind treatment . RESULTS : Telmisartan and amlodipine treatments significantly decreased trough supine systolic blood pressure and DBP ( P < 0.001 , measured conventionally ) to a similar extent ( by 13.1/7.1 and 14.0/7.1 mmHg , respectively , at the end of 12 weeks ' treatment ) compared with placebo . Both drugs also significantly reduced 24 h mean systolic blood pressures and DBP compared with placebo ( P < 0.0001 ) , measured using ABPM , maintaining control of blood pressure throughout the dosing period . Reductions in DBP with telmisartan were greater ( P < 0.05 ) than those with amlodipine during the night-time interval and the last 4 h of the dosing period . Twenty-four-hour mean ABPM DBP < 85 mmHg were observed in 71 % of telmisartan patients and in 55 % of patients administered amlodipine . In addition , heart rates in patients treated with telmisartan were lower than heart rates in those treated with amlodipine during the final 4 h of the dosing period ( P = 0.0003 ) and during the morning interval ( P = 0.005 ) . Generally , both telmisartan and amlodipine were well tolerated , however , drug-related edema occurred significantly more commonly ( P < 0.05 ) among the patients administered amlodipine than it did among patients administered either telmisartan or placebo . CONCLUSIONS : Clinic blood pressure measurements detected no difference between the antihypertensive effects and duration s of action of telmisartan and amlodipine , both agents producing statistically significant reductions compared with placebo . ABPM measurements , however , revealed differences between the efficacies at specific time points within the dosing periods . These findings highlight the potential importance of the use of ABPM for evaluating and comparing efficacies of antihypertensive agents
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 .