EFFECT OF HYPOTENSIVE DRUGS ON THE CIRCADIAN BLOOD-PRESSURE PATTERN IN ESSENTIAL-HYPERTENSION - A COMPARATIVE-STUDY

To compare the effect of four drug groups on the ambulatory circadian blood pressure (BP) pattern, amiloride hydrochlorothiazide, atenolol, nifedipine, and perindopril (5/50 mg/d, 100 mg/d, 40 mg/d, and 4 mg/d respectively, for 14 days) were alternated in each of 20 essential hyp ertension patients. Diuretics induced the largest (P < 0.05) drop in m ean 24-hour systolic BP (-12 mmHg, P < 0.001). Atenolol reduced only i ts standard deviation, and nifedipine reduced only the mean daytime sy stolic BP (P < 0.05). The mean 24-hour diastolic BP was equally reduce d by all drugs except nifedipine, which only reduced (P < 0.05) the me an daytime value. The mean 24-hour heart rate was decreased by atenolo l (P < 0.001), increased by diuretics (P < 0.05), and unchanged with p erindopril, while nifedipine increased (P < 0.05) only its night-time value. In conclusion, diuretics were the strongest agents in reducing systolic BP, atenolol the only agent that reduced variability, perindo pril the only agent that did not affect the heart rate, and nifedipine reduced only daytime BP values.