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Vol. 96, Suppl. 1, 2001
Issue release date: 2001
Cardiology 2001;96(suppl 1):3–9

A Comparison of Selected Antihypertensives and the Use of Conventional vs Ambulatory Blood Pressure in the Detection and Treatment of Hypertension

Ebbs D.
Didcot Health Centre, Didcot, UK

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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 (≧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.

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  1. Collins R, Peto R, MacMahon S, Herbert P, Fiebach NH, Eberlein KA, Godwin J, Qizilbash N, Taylor JO, Hennekens CH: Blood pressure, stroke, and coronary heart disease. Part II. Short-term reductions in blood pressure: Overview of randomised drug trials in their epidemiological context. Lancet 1990;335:827–838.
  2. Health Survey for England 1996, Vol. 1, London. The Stationery Office, 1998.
  3. Ramsay LE, Williams B, Johnston DG, MacGregor G, Poston L, Potter J, Poulton N, Russell G: Guidelines for management of hypertension: Report of the third working party of the British Hypertension Society. J Hum Hypertens 1999;13:569–592.
  4. Joint National Committee: Sixth report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. Arch Intern Med 1997;157:2413–2446.
  5. Prasad N, Isles C: Ambulatory blood pressure monitoring: A guide for general practitioners. Br Med J 1996;313:1535–1541.
  6. Guidelines Subcommittee: World Health Organisation/International Study of Hypertension Guidelines for the Management of Hypertension. J Hypertens 1999;17:151–183.
  7. Santucciu C, Parati G, Ulian L, Omboni S, Mancia G: The difference between clinical ambulatory measured blood pressure and daily monitored pressure does not reflect the ‘white-coat’ effect. Cardiologia 1997;42:1067–1069.
  8. Ford V: A 24-hour tool. Ambulatory blood pressure monitoring. Adv Nurse Pract 1997;5:43–46.
  9. Gibbs CR, Murray S, Beevers DG: The clinical value of ambulatory blood pressure monitoring. Heart 1998;79:115–117.
  10. Staessen JA, Byttebier G, Buntix F, Celis H, O’Brien ET, Fagard R: Antihypertensive treatment based on conventional or ambulatory blood pressure measurement. JAMA 1997;278:1065–1072.
  11. Mezzetti A, Pierdomenico SD, Costantini F, Romano F, Bucci A, Di Goacchino M, Cuccurullo F: White-coat resistant hypertension. Am J Hypertens 1997;10:1302–1307.
  12. Pickering TG: A new role for ambulatory blood pressure monitoring? JAMA 1997;278:1110.
  13. Zanchetti A: Twenty-four hour ambulatory blood pressure evaluation of antihypertensive agents. J Hypertens 1997;15 (suppl):S21–S25.
  14. Kawano Y, Tochikubo O, Watanabe Y, Miyajima E, Ishii M: Doxazosin suppresses the morning increase in blood pressure and sympathetic nervous activity in patients with essential hypertension. Hypertens Res 1997;20:149–156.
  15. Watts RW, Wing LM: A placebo-controlled comparison of diltiazem and amlodipine monotherapy in essential hypertension using 24-hour ambulatory monitoring. Blood Pressure 1998;7:25–30.
  16. Whelton A, Dunne B, Glazer N, Kostis JB, Miller WE, Rector DJ, Tresnewsky ON: Twenty-four hour blood pressure effect of once-daily lisinopril, enalapril, and placebo in patients with mild to moderate hypertension. J Hum Hypertens 1992;6:325–331.
  17. Weir MR, Reisin E, Falkner B: Nocturnal reduction of blood pressure and the antihypertensive response to a diuretic or angiotensin converting enzyme inhibitor in obese hypertensive patients. TROPHY Study Group. Am J Hypertens 1998;11:914–920.
  18. Grimm RH Jr, Grandits GA, Cutler JA, Stewart AL, McDonald RH, Svendsen K, Prineas RJ, Liebson PR: Relationships of quality-of-life measures to long-term lifestyle and drug treatment in the Treatment of Mild Hypertension Study. Arch Intern Med 1997;157:638–648.
  19. Langdon CG, Packard RS: Doxazosin in hypertension: Results of a general practice study in 4,809 patients. Br J Clin Pract 1994;48:293–298.

    External Resources

  20. Tan KW, Frise SA: Efficacy and tolerability of doxazosin versus enalapril in the treatment of patients with mild-to-moderate hypertension. Clin Ther 1997;19:459–470.

    External Resources

  21. Ames RP, Kiyasu JY: Alpha-1 adrenoceptor blockade with doxazosin in hypertension: Effects on blood pressure and lipoproteins. J Clin Pharmacol 1989;29:123–127.

    External Resources

  22. Daae LN, Westlie L: A 5-year comparison of doxazosin and atenolol in patients with mild-to-moderate hypertension: Effects on blood pressure, serum lipids, and coronary heart disease risk. Blood Pressure 1998;7:39–45.
  23. Parati G, Omboni S, Staessen J, Thijs L, Fagard R, Ulian L, Mancia G: Limitations of the difference between clinic and daytime blood pressure as a surrogate measure of the ‘white-coat’ effect. Syst-Eur investigators. J Hypertens 1998;16:23–29.

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