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 .
Antihypertensive efficacy of lercanidipine at 2.5, 5 and 10 mg in mild to moderate essential hypertensives assessed by clinic and ambulatory blood pressure measurements
Objective To evaluate the antihypertensive effect of lercanidipine once a day at three different doses ( 2.5 , 5 and 10 mg ) by clinic and ambulatory blood pressure . Methods After 3 weeks of a placebo run-in , 243 mild to moderate essential hypertensives ( mean ± SD age 51 ± 8 years ) were r and omly allocated to lercanidipine at 2.5 , 5 or 10 mg or a placebo for 4 weeks , in a double-blind parallel-group design . At the end of each period , supine clinic blood pressure ( st and ard sphygmomanometry ) and 24 h ambulatory blood pressure ( Spacelabs 90207 ) were measured . The duration and homogeneity of the antihypertensive effect of the active drug compared with placebo over 24 h was evaluated by calculating the smoothness index , the ratio of the mean of the 24 hourly blood pressure changes to the corresponding SD . The higher the smoothness index , the greater and the smoother is the antihypertensive effect of a drug over the 24 h. Results In 211 patients with valid clinic blood pressure data at the end of treatment  , larger systolic/diastolic blood pressure reductions were found in the 5 mg ( 10 ± 12/8 ± 6 mmHg ; P < 0.05 versus placebo , diastolic blood pressure only ) and the 10 mg ( 12 ± 1/9 ; ± 7 mmHg ; P < 0.05 versus placebo , both pressures ) lercanidipine groups than in the placebo ( 5 ± 11/4 ± 8 mmHg ) and 2.5 mg lercanidipine ( 7 ± 12/6 ± 7 mmHg ) groups . In 105 patients with complete 24 h  ambulatory blood pressure recordings , there were significantly ( P < 0.05 versus placebo ) larger reductions in the 10 mg ( 9 ± 7/7 ± 5 mmHg ) than the 2.5 mg ( 1 ± 10/1 ± 6 mmHg ) and placebo ( 2 ± 6/1 ± 4 mmHg ) groups . The reduction in 24 h blood pressure with 5 mg lercanidipine ( 6 ± 7/4 ± 5 mmHg ) was significantly greater compared with placebo for diastolic pressure only , and when hourly average blood pressure changes were considered , this reduction did not extend to the final hours of the dosing interval . No significant changes in the clinic or 24 h heart rate were induced by placebo or lercanidipine . The smoothness index was significantly ( P < 0.05 ) lower for 2.5 mg lercanidipine and placebo ( 0.2 ± 0.5 and 0.3 ± 0.7 for systolic and 0.1 ± 0.4 and 0.2 ± 0.7 for diastolic blood pressure ) than for the 5 and 10 mg doses ( 0.7 ± 1 and 1 ± 0.7 for systolic and 0.7 ± 1 and 1 ± 0.9 for diastolic blood pressure ) . Conclusions At a dose of 10 mg , lercanidipine had a significant and durable antihypertensive effect over 24 h , but at 5 mg , the effect was less consistent and did not last 24 h. There was no clinical ly relevant reduction in clinic or ambulatory blood pressure with 2.5 mg lercanidipine , and the effect was superimposable on that of placebo
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 .