EFFICACY OF ONCE-DAILY AMLODIPINE IN THE CONTROL OF 24-HOUR BLOOD-PRESSURE USING AMBULATORY BLOOD-PRESSURE MONITORING

To evaluate the efficacy, tolerance, and acceptance of once-daily amlo dipine in the control of 24-hour blood pressure (BP), we conducted an open-label, uncontrolled trial in 20 patients (17 men and 3 women) wit h mild-to-moderate hypertension and without evidence of secondary hype rtension except as a result of nephropathy. A 2-week washout placebo p eriod was followed by a 12-week period of active treatment. The starti ng dose of amlodipine was 5 mg once daily; this was increased to 10 mg once daily if BP was not controlled within 6 weeks of starting treatm ent. Clinic and ambulatory BP measurements were obtained before starti ng active treatment (week 0) and then at 6 and 12 weeks after the star t of treatment. The mean age (+/-SD) was 49.2 +/- 13.7 years. Mean cli nic systolic BP fell from 162.4 +/- 15.4 mm Hg at week 0 to 136.8 +/- 8.7 mm Hg at week 12. Clinic diastolic BP fell from 102.8 +/- 5.1 mm H g at week 0 to 81.3 +/- 6.1 mm Hg at week 12. Ambulatory systolic BP f ell from 147.8 +/- 8.8 mm Hg at week 0 to 136.0 +/- 10.6 mm Hg at week 12, Ambulatory diastolic BP fell from 90.4 +/- 4.5 mm Hg at week 0 to 81.0 +/- 5.0 mm Hg at week 12. There was a significant reduction in s ystolic BP between week 0 and week 6 (P = 0.0001), as well as between week 0 and week 12 (P = 0.0008), Similarly, significant reductions wer e obtained in diastolic BP between week 0 and week 6 (P = 0.0002), as well as between week 0 and week 12 (P = 0.001). The drug amlodipine wa s well tolerated and well accepted by patients. The results indicate t hat monotherapy with amlodipine 5 mg once daily is effective in contro lling BP over a 24-hour period.