HEMODYNAMIC AND 24-H BLOOD-PRESSURE PROFILE OF AMLODIPINE MONOTHERAPY

Objectives: To test the therapeutic efficacy, hemodynamic profile, cha nges in arterial compliance, left ventricular mass and side effects of amlodipine monotherapy in hypertensive Egyptians. Background: Amlodip ine is a dihydropyridine calcium antagonist with prolonged duration of action. Its hemodynamic and hypotensive effects were not reported in hypertensive Egyptians. Hypertension is a major health problem in Egyp t. Racial differences in hypotensive efficacy of some drugs have been described. Methods: Thirty-two hypertensive patients in stages I and I I WHO were recruited from a hypertension clinic. Following 2-4 weeks p lacebo period 23 patients satisfied inclusion criteria of DBP 95-115 m m Hg. Active amlodipine therapy 5-10 mg was given once daily. Office B P was measured at monthly intervals for 3 months. Ambulatory 24-h bloo d pressure (ABP) and echo-Doppler studies were performed at the end of placebo and after amlodipine therapy. Results: Twenty patients comple ted the 3 months active treatment period, their age ranged from 30-63 years; 13 were males, body mass index (BMI) was 31 +/- 14 kg/m(2) (mea n +/- s.d.). Office systolic (S) BP decreased from 152 +/- 14 to 133 /- 8 mm Hg, diastolic (D) BP from 104 +/- 6 to 89 +/- 8 mm Hg, BP was normalised (<140/90 mm Hg) in 13 patients. Heart rate did not change. ABP 24 h, daytime, night time and early morning readings decreased sig nificantly. Amlodipine attenuated SEP rises (>140 mm Hg) from 62% to 2 8% (P < 0.001) and DBP (>90 mm Hg) from 73% to 46% (P < 0.001). Cardia c index and left ventricle (LV) functional shortening did not change w hile systemic vascular resistance decreased from 35 to 29.8 units (P < 0.001). LV mass index decreased from 101 to 96 gm/m(2) (NS) and arter ial compliance increased from 0.97 to 0.99 ml/mm Hg (NS). Oedema of lo wer limbs developed in six patients and was the only side effect.Concl usion: Amlodipine effectively lowered BP when given as monotherapy to hypertensive Egyptians. It did not influence heart rate, cardiac index or myocardial contractility. Change in LV mass and arterial complianc e were not significant.