Hypertension is usually diagnosed and treated based on blood pressure readings obtained in the clinical office. Recently usefulness of ambulatory blood pressure monitoring (ABPM) which provide patients’ non-dipping pattern, morning surge and white-coat effect is highlighted. We designed multicenter, prospective, open-label trial to evaluate the efficacy of amlodipine besylate in the 24 hr ambulatory blood pressure change (ACROSS study).Design and Method:
We investigated 186 persons with a systolic blood pressure of 140∼180 mmHg, or a diastolic blood pressure of 90∼110 mmHg, but without secondary hypertension. We measured ABPM at the screening and 8 weeks after the administration of amlodipine. The primary outcome was the rate to reach a 24hr-mean blood pressure target of less than 130/80 mmHg measured by ABPM after amlodipine treatment.Results:
The mean age was 52.6 ± 11.96 years and 110 (59.1%) participants were men. At 8 weeks after amlodipine treatment, 46 (24.7%) participants reached a mean blood pressure target, and 24hr-mean blood pressure of participants were 130.5 ± 11.24/83.7 ± 8.11 mmHg. Mean blood pressure reduction of systolic and diastolic blood pressure between two ABPM measurements were 13.1 ± 10.14 mmHg and 8.7 ± 7.10, respectively (P < 0.001). Trough-to-peak ratio of systolic blood pressure was 0.50 ± 1.23 and that of diastolic blood pressure was 0.36 ± 1.40. Smoothness index of systolic blood pressure and diastolic blood pressure were 0.85 ± 0.69 and 0.74 ± 0.68, respectively. After amlodipine treatment, ratio of non-dipper to dipper in systolic blood pressure and diastolic blood pressure were not changed with statistical significance (P = 0.714 and P = 1.00). Morning blood pressure surge was reduced by 0.51 ± 15.62 mmHg, however, it was not statistically significant (P = 0.668).Conclusions:
Amlodipine therapy was effective in reduction of 24-hr mean blood pressure in hypertensive patients. However, non-dipping pattern and morning surge were not changed after 8 weeks therapy.