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 .
Failure of psychological interventions to lower blood pressure: a randomized controlled trial
Background Previous studies have suggested that psychological interventions may be effective in reducing blood pressure . Using rigorous methodology and 24-hour monitoring of ambulatory blood pressure , we compared 2 psychological interventions with treatment using a first-line antihypertensive drug in terms of their efficacy in lowering blood pressure in patients with mild primary hypertension . Methods In this prospect i ve , open-label r and omized controlled trial ( RCT ) , 65 adult patients with mild , uncomplicated hypertension were r and omly assigned to receive one of the following interventions for 12 weeks : ( 1 ) pharmacotherapy with hydrochlorothiazide 12.5 titrated to 25 mg/d ; ( 2 ) individualized behavioural psychotherapy , consisting of ten 1-hour sessions of stress reduction training with a psychologist ; or ( 3 ) self-help psychotherapy , consisting of a 1.5-hour session with a psychologist and then daily sessions that involved reading a self-help manual and listening to an audiotape . The primary outcome measure was mean change in ambulatory blood pressure from baseline to week 12 . Resting blood pressure readings were taken in the clinic , and adverse events were recorded . Results Monitoring of ambulatory blood pressure over 24 hours showed that hydrochlorothiazide therapy significantly reduced both systolic and diastolic blood pressure relative to baseline , and that this reduction was significantly greater than that achieved with either individualized behavioural psychotherapy or self-help psychotherapy ( mean reduction [ st and ard error ; SE ] −11.03 [ 2.53 ] / −6.06 [ 1.56 ] mm Hg v. −0.08 [ 2.38 ] / 0.29 [ 1.47 ] mm Hg v. −1.23 [ 2.83 ] / −0.71 [ 1.75 ] mm Hg , respectively ; p = 0.01 ) . Neither form of psychological therapy significantly lowered 24-hour ambulatory blood pressure relative to baseline . Conclusion For patients with primary elevated blood pressure , 2 psychological interventions did not lower 24-hour ambulatory blood pressure , whereas hydrochlorothiazide  reduced blood pressure , as expected . The findings of this RCT represent an important addition to the evidence for health care practitioners and for patients seeking psychological interventions to reduce blood pressure
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 .