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Amlodipine Appears To Provide Greater Reduction In Blood Pressure Than Does Losartan
A DGReview of :"The effects of amlodipine compared to losartan in patients with mild to moderately severe hypertension."
Journal of Clinical Hypertension (Greenwich, Conn.)
02/06/2003
By James Adams
Treatment with amlodipine results in greater reductions in most blood pressure measurements when compared with losartan treatment for mild to moderately severe hypertension.
Investigators from Lenox Hill Hospital and New York University School of Medicine compared the calcium channel blocker amlodipine with the angiotensin receptor blocker losartan in 440 adult patients with mild to moderate hypertension.
Patients were randomized to receive either 5 milligrams of amlodipine or 50 milligrams of losartan once per day. In those patients who failed to reduce their diastolic blood pressure to 90 mm Hg or less after six weeks, amlodipine was increased to 10 milligrams daily or 12.5 milligrams of hydrochlorothiazide (HCTZ) was combined with the original dose of losartan.
Diastolic blood pressure equal to or below 90 mm Hg was achieved by 43.6% of the amlodipine patients and 42.3% of the losartan patients. Seventy-one percent of the amlodipine and 81% of the losartan patients who continued treatment with the original dose reached blood pressure goals. The difference between the two groups was not significant.
However, among those patients who required dosage adjustments, a significantly higher number of amlodipine patients reached blood pressure goals. Fifty-nine percent of the amlodipine patients compared with 42% of the losartan/HCTZ patients reached blood pressure goals by the end of the study.
Combining results from high- and low-dose patients showed that 63.8% of amlodipine patients and 55.1% of losartan patients reached a diastolic blood pressure equal to or below 90 mm Hg. This difference, however, was not statistically significant.
Amlodipine did provide a significantly greater reduction in both diastolic and systolic blood pressure from baseline to the end of treatment. Also, African American and Hispanic patients had significantly better response rates with amlodipine than with losartan.
J Clin Hypertens (Greenwich) 2003;5:1:17-23.
"The effects of amlodipine compared to losartan in patients with mild to moderately severe hypertension."
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