The aim of our study was to assess the effect of antihypertensive treatment (beta-blockers (BB), angiotensin I receptor antagonists (ARA), calcium antagonists (AC), angiotensin converting enzyme inhibitors (ACEI) on the difference between clinical and ambulatory blood pressure level.Design and method:
We analyzed 292 ambulatory blood pressure monitoring (ABPM) data of AH patients without serious concomitant diseases. The difference between clinical and ambulatory blood pressure level was assessed as the difference between clinical BP measurement and mean daytime BP. The inclusion criteria were: >6-days wash-out period; two ABPM (SpaceLabs 90207) sessions before treatment and during treatment; daytime BP before treatment >140/90 and < 160/110 mmHg; 2–3 months treatment period with mean therapeutic doses. The BB group included metoprolol receiving patients (35), ARA group - losartan and telmisartan (36), ACEI group - captopril and enalapril (35), AC group - amlodipin (40). We used Spearman Partial Coefficient for correlation analysis adjusted for age, sex and duration of AH.Results:
We found that all antihypertensive drugs significantly decreased systolic and diastolic BP (SBP, DBP) levels. Long-term BB therapy significantly reduced difference between systolic and diastolic clinical and ambulatory blood pressure diastolic. Antihypertensive treatment with other drugs has not significantly reduced the difference between clinical and ambulatory blood pressure (see table).Conclusions:
BB decreased difference between clinical and ambulatory blood pressure. Probably BB reduced stress - induced increase of the sympathetic nervous system activity during clinic visit and therefore clinic BP level more significantly than other drugs.