A comparison of selected antihypertensives and the use of conventional vs ambulatory blood pressure in the detection and treatment of hypertension.

Abstract

This multicenter, randomized, double-blind, parallel group study was undertaken to determine the effectiveness of selected antihypertensives (doxazosin, amlodipine, enalapril, and bendrofluazide) in maintaining 24-hour control of blood pressure (BP). The predictive value of ambulatory (A)BP versus clinic (C)BP measurements as a method for detecting patients with hypertension was also evaluated. A total of 204 patients were screened and of these 110 were diagnosed as mild to moderately hypertensive with clinic diastolic BP 100-110 mm Hg (> or =95 mm Hg in patients with coronary heart disease risk factors). The 4 antihypertensives were all equally effective at controlling BP over 24 h, as shown by 24-hour ABP measurements. The incidence of adverse events was similar for all 4 treatment groups; headache was the most common event, being reported by 22 patients (20%). There was a clinically relevant reduction in total cholesterol for the doxazosin (-15.4 mg/dl) and amlodipine (-11.6 mg/dl) treatment groups in comparison with enalapril and bendrofluazide. Our results from ABP measurements suggest that the antihypertensives studied are effective first-line therapy in the regulation of hypertension and that ABP is a reproducible measure. ABP may also be useful in identifying patients with various types of high BP, for instance those with 'white coat' hypertension, enabling more accurate screening and diagnosis.

• Authors: D Ebbs
• Journal: Cardiology (Cardiology) Vol. 96 Suppl 1 Pg. 3-9 ( 2001) ISSN: 0008-6312 [Print] Switzerland
• PMID: 11574740 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: Copyright 2001 S. Karger AG, Basel

Chemical References

• Antihypertensive Agents
• Amlodipine
• Bendroflumethiazide
• Enalapril
• Doxazosin

Topics

• Adult
• Aged
• Amlodipine (therapeutic use)
• Analysis of Variance
• Antihypertensive Agents (adverse effects, therapeutic use)
• Bendroflumethiazide (therapeutic use)
• Blood Pressure (drug effects)
• Blood Pressure Determination (methods)
• Blood Pressure Monitoring, Ambulatory
• Diastole (drug effects)
• Double-Blind Method
• Doxazosin (therapeutic use)
• Enalapril (therapeutic use)
• Female
• Humans
• Hypertension (diagnosis, drug therapy, physiopathology)
• Male
• Middle Aged
• Systole (drug effects)
• Treatment Outcome