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 .
Treatment of patients with essential hypertension: amlodipine 5 mg/benazepril 20 mg compared with amlodipine 5 mg, benazepril 20 mg, and placebo.
This multicenter , double-masked , r and omized , parallel-group study compared the efficacy , tolerability , and safety of amlodipine 5 mg/benazepril 20 mg , amlodipine 5 mg , benazepril 20 mg , and placebo in patients with essential hypertension . After a placebo run-in period , 308 patients ( all white ) were r and omized to treatment groups and took medication once daily for 8 weeks . Blood pressure was measured after 4 and 8 weeks of treatment in the 23- to 26-hour period after dosing . Patients wore a noninvasive blood pressure monitor  for 24 hours before r and omization and before the final visit . Investigators recorded adverse experiences at r and omization and at study weeks 4 and 8 , and obtained specimens for laboratory testing at r and omization and at study week 8 . Three hundred seven patients were evaluated for efficacy , and 308 for tolerability and safety . At end point ( the last postr and omization measurement for each patient ) , the reduction in mean sitting diastolic blood pressure with the amlodipine 5 mg/benazepril 20 mg treatment was statistically significantly greater than with any comparative therapy . The results of 24-hour monitoring showed that the amlodipine/benazepril treatment , unlike monotherapy , maintained the hourly mean diastolic blood pressure at < or = 90 mm Hg . A responder rate of 87.0 % was observed with amlodipine 5 mg/benazepril 20 mg versus 67.5 % , 53.3 % , and 15.8 % with amlodipine , benazepril , and placebo , respectively . This difference between the amlodipine/benazepril treatment group and each comparative single-agent treatment group was statistically significant . Drug-related adverse events occurred in 15.6 % of patients in the amlodipine/benazepril group and in 24.7 % , 6.5 % , and 11.7 % of patients in the amlodipine , benazepril , and placebo groups , respectively . Edema occurred less often in the amlodipine/benazepril group than in the amlodipine group . Overall , once-daily therapy with amlodipine 5 mg/benazepril 20 mg provided an antihypertensive effect that was statistically and clinical ly superior to amlodipine 5 mg alone , benazepril 20 mg alone , and placebo , was well tolerated , and was associated with less edema than the amlodipine treatment
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 .