Long-term blood pressure variability (BPV) has been known to be associated with increased risk of cardiovascular disease. There had been a few reports which showed the beneficial effects of amlodipine and comparably hazardous effect of atenolol on BPV. However there is lack of data about the different effect of antihypertensives on BPV which are used in real clinical field.Design and Method:
A total of 92 patients who diagnosed hypertension was included in this study. All patients measured and recorded morning and evening BP every day at home by themselves. We checked previous medical history, laboratory results and echocardiography at the initiation of study. The medication for hypertension was on physician's discretion for each patient. BPV was evaluated with standard deviation (SD) of systolic BP, coefficient of variation (CV), maximum minus minimum BP difference (MMD) and variation independent of mean systolic BP (VIM).Results:
All antihypertensives including CCB, beta blocker, ACE inhibitor or ARB, and diuretics did not showed independent effect on BPV. However the patients who were taking CCB showed lower morning MMD among the patients taking multiple agents compared with the patients who were not. (46.7 ± 17.9 vs 56.8 ± 22.5, p = 0.038) The combination of ACE inhibitor or ARB with diuretics showed higher MMD compared with other combinations. (87.0 ± 1.4 vs. 50.3 ± 19.5, p = 0.011) The amlodipine and atenolol did not showed specific correlation with BPV, but patients with bisoprolol significantly lower VIM and CV. (9.2 ± 2.6 vs. 12.1 ± 4.2, p = 0.015, 6.5 ± 1.9 vs 8.4 ± 3.0, p = 0.022, respectively).Conclusions:
The CCB can be helpful to reduce BPV in combination treatment since the combination of ACE inhibitor or ARB and diuretics would be not good for reducing BPV. We should consider the different effect on BPV when we make a choice of antihypertensives.