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Effects of doxazosin mesylate versus nifedipine on blood pressure variability in hypertensive patients

a randomized crossover study (SIMILAR)

Shi, Jinga,,*; Liang, Desenb,,*; Pan, Yujiaoa,,*; Zhang, Songa; He, Meijiaoa; Zhang, Haiyua; Liu, Guangzhonga; Gong, Yongtaia; Wang, Wennana; Cang, Haia; Li, Yuea,,c

doi: 10.1097/MBP.0000000000000388
Clinical Trials
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Objective Blood pressure variability (BPV) is a powerful predictor of end-organ damage, cardiovascular events and mortality independently of the BP level. Calcium channel blockers may offer an advantage over other first-line antihypertensive drugs by preventing increased BPV. But the effect of alpha-receptor blockers on BPV in hypertensive patients is still unclear.

Methods In this crossover trial, 36 hypertensive patients were randomly assigned to two groups, receiving doxazosin mesylate gastrointestinal therapeutic system (GITS) (4 mg/day) or nifedipine GITS (30 mg/day) for 12 weeks, followed by a 2-week washout period then a 12-week crossover phase. At baseline and after 12-week treatment, 24-hour ambulatory BP monitoring was performed. BPV was evaluated through standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) of systolic BP (SBP) and diastolic BP (DBP) during daytime, nighttime and over 24 hours.

Results After 12-week treatment, both doxazosin and nifedipine significantly decreased SBP and DBP (P < 0.05), whereas no between-group differences were shown (P>0.05). Systolic BPV (24-hour SD, CV, and ARV; daytime SD; nighttime SD and CV) and diastolic BPV (24-hour SD and ARV) were significantly lowered by nifedipine (P < 0.05); doxazosin resulted in significant reductions of systolic BPV (24-hour SD, CV and ARV; daytime SD; nighttime SD) and diastolic BPV (nighttime SD and CV) (P < 0.05). Doxazosin was revealed to be as effective as nifedipine for reducing BPV (P > 0.05) except for 24-hour SBP ARV.

Conclusions Doxazosin mesylate GITS had similar therapeutic effects on BP, BP SD, and BP CV lowering as nifedipine GITS in patients with mild-to-moderate essential hypertension.

Departments of aCardiovascular

bGeneral Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang

cInstitute of Metabolic Disease, Heilongjiang Academy of Medical Science, Harbin, People’s Republic of China

* Drs Jing Shi, Desen Liang and Yujiao Pan contributed equally to this work.

Received 12 January 2019 Accepted 17 April 2019

Correspondence to Yue Li, PhD, Cardiovascular Department, The First Affliated Hospital, Harbin Medical University, No. 23 Youzheng Street, Nangang District, Harbin, Heilongjiang 150001, People’s Republic of China, Tel: 86 451 85555673; fax: 86 451 53607428; e-mail: ly99ly@vip.163.com

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