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Title: Persistence of the antihypertensive efficacy of amlodipine and nifedipine GITS after two 'missed doses': A randomised, double-blind comparative trial in Asian patients
Authors: I. Ongtengco
D. Morales
J. Sanderson
Z. R. Lu
L. J. Beilin
V. Burke
I. B. Puddey
S. Tanomsup
H. Dayi
P. Rahardjo
Dato R. Zambahari
C. Y. Chen
A. A. Soenarta
P. Buranakitjaroen
C. Tan
T. K. Soon
D. J. Wu
St. Luke's Medical Center Quezon City
Manila Doctors Hospital
Chinese University of Hong Kong
Xi'an Medical University
University of Western Australia Faculty of Medicine and Dentistry
Mahidol University
Beijing Red Cross Chaoyang Hospital
National General Hospital Cipto Mangunkusumo
Institut Jantung Negara Kuala Lumpur
Kuang Tien General Hospital
Rumah Sakit Harapan Kita
Hospital Universiti Kebangsaan Malaysia
Changi General Hospital
Chung Shan Medical University
Keywords: Medicine
Issue Date: 1-Nov-2002
Citation: Journal of Human Hypertension. Vol.16, No.11 (2002), 805-813
Abstract: Suboptimal management of hypertension is often a result of poor patient compliance in the form of missed doses of their antihypertensive medication. This multicentre, randomised, double-blind, parallel-group trial was designed to compare the persistence of the antihypertensive efficacy of the amlodipine and nifedipine gastrointestinal therapeutic system (GITS) after two 'missed doses', and also to compare the drugs' overall efficacy and safety in Asian patients with mild-to-moderate essential hypertension. Following a 2-week placebo run-in period, 222 patients were randomised to receive either amlodipine (5 mg daily, increased after 6 weeks if necessary to 10 mg daily, n = 109) or nifedipine GITS (30 mg daily, increased after 6 weeks if necessary to 60 mg daily; n = 113) for 12 weeks. A placebo was then substituted for further 2 days with continuous ambulatory blood pressure (BP) monitoring. The increases in the last 9 h of mean ambulatory BP on day 2 after treatment withdrawal were significantly less with amlodipine than with nifedipine GITS: 4.4 ± 7.0 vs 11.2 ± 11.3 mmHg for systolic BP (P≤0.0001) and 2.4 ± 6.3 vs 6.0 ± 6.0 mmHg for diastolic BP (P≤0.0002). Significant differences between the two drugs in mean 24-h ambulatory BP levels were already evident on day 1 after withdrawal, even though there were no significant differences on the final day of treatment. No differences in safety parameters were observed, and neither drug caused any serious or severe treatment-related adverse events. In conclusions, amlodipine provides greater protection than nifedipine GITS against loss of BP control following missed doses.
ISSN: 09509240
Appears in Collections:Scopus 2001-2005

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