DIFFERENCES BETWEEN AMLODIPINE AND LISINOPRIL IN CONTROL OF CLINIC AND 24 HOUR AMBULATORY BLOOD PRESSURES

The anti-hypertensive efficacy of once-daily amlodipine (up to 10 mg) and lisinopril (up to 20 mg) were compared in terms of clinic and ambu latory blood pressure (BP) control, in an observer-blind, two-period c rossover study. Following a 4-week placebo run-in period, patients und erwent two active treatment phases each lasting 12 weeks and separated by a 4-week washout period. Sixty patients with a supine diastolic BP between 90 and 120 mm Hg were included, irrespective of whether or no t they had received previous anti-hypertensive medication. Amlodipine reduced supine systolic and diastolic clinic BP significantly more tha n lisinopril (-20 +/- 2/-14 +/- I vs -11 +/- 3/-7 +/- 1 mm Hg; P = 0.0 2/ P = 0.001) 24 h post-dose. Clinic standing diastolic BP was also si gnificantly reduced with amlodipine compared with lisinopril (P = 0.05 ). Both drugs produced control of mean ambulatory BP relative to basel ine over 24 h. Amlodipine showed more consistent control of BP over th e 24-h period in contrast to lisinopril which exerted its greatest eff ect during the daytime.