AMLODIPINE VERSUS ATENOLOL IN ESSENTIAL-HYPERTENSION

The efficacy and safety of amlodipine (2.5-10 mg) once daily was compa red with atenolol (50-100 mg) once daily In patients with mild-to-mode rate essential hypertension in a randomized, double- blind, parallel, placebo-controlled study. A total of 125 patients were randomly alloca ted at the end of a 4-week run-in placebo period to 8 weeks of double- blind treatment with amlodipine (n = 41), atenolol (n = 43), or placeb o (n = 41). The placebo group had small mean changes in supine and sta nding blood pressure compared with baseline. The mean blood pressure c hanges from baseline 24 hours postdose in the amlodipine group (mean d airy dose 8.8 mg) were -12.8/-10.1 mm Hg for supine blood pressure and -11.5/-9.8 mm Hg for standing blood pressure (p <0.001 compared with placebo), and for the atenotol group (mean daily dose 83.7 mg) the cha nges were -11.3/-11.7 mm Hg for supine blood pressure and -13.3/-12.3 mm Hg for standing blood pressure(p <0.001 compared with placebo). The re were no statistically significant blood pressure differences betwee n active treatments. The responder rates for amlodipine, atenolol, and placebo were 61.1, 64.9, and 11.1%, respectively. The blood pressure values taken over the 24-hour period at final visit revealed that amlo dipine and atenolol maintained the supine blood pressure less than or equal to 140/90 mm Hg throughout the period of observation; the corres ponding time-effect curve for the placebo group was clearly in the hyp ertensive range. Heart rate was significantly lowered by atenolol only . Both amlodipine and atenolol were well tolerated. Only 1 patient was withdrawn due to adverse effects (development of peripheral edema, ar thralgia and fatigue) related to amlodipine. This study demonstrates t hat once-daily therapy with amlodipine or atenolol was well tolerated In patients with mild-to-moderate essential hypertension and provided control of blood pressure throughout the 24-hour dosing interval.