A comparison of selected anti hypertensives and the use of conventional vsambulatory blood pressure in the detection and treatment of hypertension

This multicenter, randomized, double-blind, parallel group study was undert aken to determine the effectiveness of selected anti hypertensives (doxazos in, amlodipine, enalapril, and bendrofluazide) in maintaining 24-hour contr ol of blood pressure (BP). The predictive value of ambulatory (A)BP versus clinic (C)BP measurements as a method for detecting patients with hypertens ion was also evaluated. A total of 204 patients were screened and of these 110 were diagnosed as mild to moderately hypertensive with clinic diastolic BP 100-110 mm Hg (greater than or equal to 95 mm Hg in patients with coron ary heart disease risk factors). The 4 anti hypertensives were all equally effective at controlling BP over 24 h, as shown by 24-hour ABP measurements . The incidence of adverse events was similar for all 4 treatment groups; h eadache was the most common event, being reported by 22 patients (20%). The re was a clinically relevant reduction in total cholesterol for the doxazos in (-15.4 mg/dl) and amlodipine (-11.6 mg/dl) treatment groups in compariso n with enalapril and bendrofluazide. Our results from ABP measurements sugg est that the antihypertensives studied are effective first-line therapy in the regulation of hypertension and that ABP is a reproducible measure. ABP may also be useful in identifying patients with various types of high BP, f or instance those with 'white coat' hypertension, enabling more accurate sc reening and diagnosis. Copyright (C) 2001 S. Karger AG, Basel.