EFFICACY AND TOLERABILITY OF AMLODIPINE IN THE GENERAL-PRACTICE TREATMENT OF ESSENTIAL-HYPERTENSION IN AN ASIAN MULTINATIONAL POPULATION

Objective: To evaluate the efficacy and tolerability of once-daily aml odipine (Pfizer Pharmaceuticals Inc.) alone or in combination with oth er antihypertensive drugs in an Asian population with essential hypert ension. Patients: An open study was undertaken in 165 male and 158 fem ale patients with uncomplicated hypertension (diastolic blood pressure 95 to 115mm Hg). Patients were recruited from 41 general practices in seven Asian countries and received amlodipine 5mg daily for 4 weeks a nd then 10mg once daily for a further 4 weeks if the target diastolic blood pressure of less than or equal to 90mm Hg or a reduction from ba seline by greater than or equal to 10mm Hg had not been achieved. This one-step dose-adjustment period was followed by a 4-week maintenance period on a constant dose. Amlodipine was the sole medication in 284 p atients and was added to other antihypertensive drugs in 39 patients u ncontrolled on previous medication. Results: 263 patients, including 1 31 males, were evaluated for efficacy at the final treatment visit. 16 6 (63%) patients achieved the target reduction in diastolic blood pres sure with amlodipine 5mg once daily, while 84 patients achieved the ta rget reduction with 10mg once daily. Systolic and diastolic blood pres sure reductions were similar irrespective of gender or age, and there were no significant changes in resting heart rate in any subgroup. In 68 patients who underwent ambulatory monitoring, the systolic and dias tolic blood pressures were reduced by once-daily amlodipine throughout the 24-hour period without change in the intrinsic circadian pattern. Amlodipine was well tolerated in all patient sub groups; adverse even ts accounted for less than 1% of treatment discontinuations, and there were no hospitalisations or deaths during the study. Investigators ra ted both the antihypertensive efficacy and tolerability of amlodipine as excellent or good in 93% of patients. Conclusion: In 263 Asian pati ents with uncomplicated essential hypertension treated in general prac tice, once-daily amlodipine in a dose of 5 or 10mg provided significan t antihypertensive efficacy either as monotherapy or in combination wi th other antihypertensive drugs while maintaining a favourable tolerab ility profile regardless of gender or age.