PS 14-31 AMBULATORY BLOOD PRESSURE LOWERING EFFICACY AND TOLERABILITY OF INITIAL HIGH DOSE OF AMLODIPINE IN MILD OR MODERATE HYPERTENSION

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Abstract

Objective:

To investigate the ambulatory blood pressure (BP) lowering efficacy and tolerability of initial high versus low dose of amlodipine in patients with mild or moderate hypertension.

Design and Method:

Eligible patients with mild or moderate hypertension (clinic systolic/diastolic BP, 140–159/90–99 mmHg) were randomly allocated 8-week treatment of levoamlodipine 2.5 mg/day (n = 351) or 5.0 mg/day (n = 350), respectively. This analysis included the patients (n = 268 and n = 263, respectively) who had valid ambulatory BP recordings at baseline and 8 weeks of follow-up.

Results:

At baseline, the mean ( ± SD) 24-h systolic/diastolic BPs were 131.7 ± 15.0/82.1 ± 10.7 mmHg and 133.7 ± 13.7/83.1 ± 9.9 mmHg in the levoamlodipine 2.5 mg/day and 5.0 mg/day groups, respectively. At 8 weeks of follow-up, the corresponding mean ( ± SE) reductions were 5.6 ± 0.7/3.6 ± 0.5 mmHg and 8.6 ± 0.8/4.9 ± 0.5 mmHg, respectively (P < 0.01/P = 0.08), with a significant (P ≤ 0.01) between-group 24-h systolic BP difference of 3.0 (95% CI 0.9 to 5.1) mmHg in favor of levoamlodipine 5 mg/day. The corresponding between-group differences in daytime and night-time systolic BPs were 2.9 (0.6 to 5.2) mmHg and 3.2 (0.9 to 5.5) mmHg, respectively (P ≤ 0.01). The incidence rate was not statistically significant (P3 0.71) for all adverse events (3.1% vs. 3.4%), serious adverse events (0.0% vs. 0.0%) or hypotension (55.6% vs. 54.0%).

Conclusions:

Initial high-dose of amlodipine increased ambulatory BP efficacy with a similar tolerability in mild or moderate hypertension.

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