Antihypertensive efficacy of amlodipine and losartan after two 'missed' doses in patients with mild to moderate essential hypertension.

Author(s): Ribeiro AB, Mion D Jr, Marin MJ, Majul C, Botero R, Lopez NR, Gonzalez S, Izurieta H, Francischetti EA, Latin American Hypertension Study (LAMHYST) Group

Affiliation(s): Hospital do Rim e Hipertensao, Escola Paulista de Medicina, Sao Paulo, Brazil. artur.ribeiro@hrim.com.br

Publication date & source: 2007-11, J Int Med Res., 35(6):762-72.

Publication type: Randomized Controlled Trial

We compared the effects of amlodipine (5-10 mg, n=94) and losartan (50-100 mg, n=94) on the lowering of blood pressure (BP) at steady state and after two missed doses, as well as on tolerability. This was a randomized, double-blind study of 12 weeks of active treatment followed by 2 days of placebo treatment. Twenty-four-hour ambulatory blood pressure monitoring and office BP measurements were performed at baseline, week 12 and after the 2-day drug holiday. After 12 weeks, amlodipine was significantly more effective than losartan in reducing both 24-h systolic blood pressure (SBP) (-18.0 versus -10.8 mmHg) and diastolic blood pressure (DBP) (-10.6 versus -8.0 mmHg). While mean SBP and DBP for both treatments increased comparably during the drug holiday, BP values remained significantly lower than baseline for both treatments. The superior BP-lowering effect of amlodipine compared with losartan was maintained during the drug holiday.