The effects of missed doses of amlodipine and losartan on blood pressure in older hypertensive patients

• Published in: Hypertension research 2017-06, Vol.40 (6), p.568-572
• Main Authors: de Leeuw, Peter W, Fagard, Robert, Kroon, Abraham A
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Amlodipine - administration & dosage; Antihypertensive Agents - administration & dosage; Blood pressure; Blood Pressure - drug effects; Diuretics; Double-Blind Method; Drug administration; Drug dosages; Female; Humans; Hypertension; Hypertension - drug therapy; Losartan - administration & dosage; Male; Older people; Treatment Outcome
• ISSN: 0916-9636; 1348-4214
• DOI: 10.1038/hr.2016.190

This randomized, double-blind, parallel-group, multicenter study compared the efficacy of amlodipine and losartan in an older hypertensive population, focusing on therapeutic coverage in the case of missed doses. Following a 4-week, single-blind, placebo washout period, 211 patients were randomly assigned to receive either 5 mg of amlodipine once daily or 50 mg of losartan once daily. Doses were doubled after 6 weeks of treatment if the diastolic blood pressure exceeded 90 mm Hg. After the 12-week treatment period, patients received the placebo for 2 days (drug holiday) to simulate two missed doses of antihypertensive medication. Twenty-four-hour ambulatory blood pressure monitoring was conducted at the end of the placebo washout period (baseline), upon completion of the 12-week treatment period (steady state), and after the 2-day drug holiday. Amlodipine was more effective than losartan in reducing patients' 24-h ambulatory blood pressure at the steady-state sampling time. The increases in 24-h blood pressure during the drug holiday averaged 6±2/2±1 mm Hg (P