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 .
Effects of telmisartan and amlodipine in combination on ambulatory blood pressure in stages 1–2 hypertension
Background Evaluation of combination therapy with antihypertensive agents by clinic blood pressure ( BP ) measurements may yield results that differ from out-of-office BP readings . This is of clinical relevance because out-of-office BP values are of prognostic importance . We studied the effects of combining telmisartan and amlodipine on ambulatory BP in patients with stages 1–2 hypertension . Methods We conducted an 8-week , placebo-controlled , double-blind , 4 × 4 factorial design trial in which 562 patients with clinic diastolic BP at least 95 and 119 mmHg or less were r and omized to receive telmisartan ( 0 , 20 , 40 , or 80 mg ) and /or amlodipine ( 0 , 2.5 , 5 , or 10 mg ) .  Ambulatory BP monitoring  was performed at baseline and after 8 weeks of treatment ; the end points of interest were the changes from baseline in 24-h systolic and diastolic BP . Secondary end points included the proportion of responders ( ≥10 mmHg BP reduction from baseline and /or < 130/80 mean 24-h BP ) and controlled patients ( < 130/80 mmHg mean 24-h BP ) . Results Combination therapies of telmisartan and amlodipine  lowered 24-h BP to a larger extent than the corresponding monotherapies at all doses . Mean reductions from baseline in 24-h BP for the combination of the highest doses of telmisartan ( 80 mg ) and amlodipine ( 10 mg ) were −22.4/−14.6 versus −11.9/−6.9 mmHg for amlodipine ( 10 mg ) and −11.0/−6.9 mmHg for telmisartan ( 80 mg ) ( P<0.0001 for each comparison ) . In addition , BP response and control rates ( 24-h BP < 130/80 mmHg ) were significantly higher with the combination therapy versus the monotherapy groups . Conclusion These findings show that telmisartan and amlodipine in combination provide substantial 24-h BP efficacy that is superior to either monotherapy in patients with stages 1 and 2 hypertension
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 .