Effects of amlodipine and nifedipine gits on diurnal/nocturnal blood pressure and heart rate of mild-moderate hypertensive patients

We have evaluated in a single-blind randomized, multicenter study the effects of Amlodipine (A) and Nifedipine GITS (N) on the 24-hour blood pressure (BP) and heart rate (HR) profiles in mild-moderate hypertensive patients; assessments by 24 hours ambulatory blood pressure monitoring (ABPM) were performed at baseline and week 8. One hundred fourteen patients initiated a placebo washout period of 2–4 weeks, and afterwards a total of 94 patients were randomized to an 8-week active treatment phase, 47 in the A group (5–10 mg/day) and 47 in the N group (30–60 mg/day). In addition patients were randomly instructed to take or omit the last daily dose in week 8. A and N significantly decreased the SBP, DBP and MBP, from baseline to week 8, in diurnal (8am–12pm), nocturnal (12pm–8am) and 24 hour measurements, in patients who did not omit the dose (NOD); no statistically significant differences were found between both study drug groups. The HR variations were not statistically significant except for the N group, where a diurnal significant increase was observed (from 75.4 ± 10.8 bpm to 78.0 ± 11.8 bpm: p = 0.017). In the omission dose group (OD), A and N significantly reduced SBP, DBP and MBP from baseline to final visit in diurnal and 24 hour measurements. Regarding nocturnal ABPM values, A but not N decreased SBP (p < 0.001) and MBP (p < 0.01). In the between study drugs comparison, there were not differences, except in the nocturnal SBP. (See Table) p = 0.046 p = 0.046 Both A and N have shown to be very effective in reducing BP along the day in mild-moderate hypertensive patients, although only A demonstrated significant nocturnal hypotensive effects when patients missed a dose.