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Amlodipine's Antihypertensive Effect Persists Longer Than Nifedipine Gastrointestinal Therapeutic System After Missed Doses

Amlodipine provides more persistent blood pressure control than does nifedipine gastrointestinal therapeutic system (GITS) following missed doses.

Missed doses of antihypertensive medication are often the cause of suboptimal management of hypertension, explain investigators from St. Luke's Medical Centre in Quezon City in the Philippines. They conducted a multi-centre, randomized, double-blind, parallel-group study comparing the persistence of amlodipine and nifedipine GITS after two missed doses in 222 Asian patients with mild to moderate hypertension.

Patients received either 5 milligrams of amlodipine or 30 milligrams nifedipine GITS daily for six weeks. Doses of each medication were doubled after six weeks if necessary for blood pressure control. Treatment continued for 12 weeks.

Mean 24-hour ambulatory blood pressure levels were similar in both groups on the last day of treatment.

After the 12-week treatment period, placebo was substituted for both medications for two days, and the effect on ambulatory blood pressure was monitored.

Results showed significant differences in mean ambulatory blood pressure between the amlodipine and nifedipine GITS groups on the first day of treatment withdrawal.

Increases in mean ambulatory blood pressure during the last nine hours of the second day of placebo administration were significantly lower in the amlodipine group.
J Hum Hypertens 2002;16:11:805-813. "Persistence of the antihypertensive efficacy of amlodipine and nifedipine GITS after two 'missed doses': a randomised, double-blind comparative trial in Asian patients."

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