A Randomized Placebo-Controlled Comparison of Amlodipine and Atenolol in Mild to Moderate Systemic Hypertension

Abstract

Summary: 

Amlodipine, a new long-acting dihydropyridine calcium antagonist, was compared with placebo and atenolol in 125 patients with mild to moderate systemic hypertension [supine diastolic blood pressure (DBP) 90-114 mm Hg]. Patients received placebo for 4 weeks, followed by a random allocation to an 8-week double-blind, once-daily treatment with amlodipine (n = 41), atenolol (n = 43), or placebo (n = 41). The changes in 24-h postdose blood pressure (BP) from baseline to final visit for amlodipine (mean daily dose 8.8 mg, range 5-10 mg) were -12.8 ± 2.0/-10.1 ± 1.2 mm Hg in supine BP and -11.5 ± 2.3/-9.8 ± 1.1 mm Hg in standing BP (p < 0.001); for atenolol (mean daily dose 83.7 mg, range 50-100 mg), the changes from baseline were -11.3 ± 2.3/-11.7 ± 1.3 mm Hg in supine BP and -13.3 ± 3.1/-12.3 ± 1.5 mm Hg in standing BP (p < 0.001); for placebo, the changes from baseline were -0.9 ± 2.8/-3.5 ± 0.9 mm Hg in supine BP and -1.6±2.6/-4.0±1.0 mm Hg in standing BP. In the study, goal response was defined as a supine DBP of <90 mm Hg or its decrease by ≥10 mm Hg. The response rates were similar for atenolol (65%) and amlodipine (61%). Both active therapies were significantly more effective than placebo. Heart rate was significantly lowered by atenolol only. Both amlodipine and atenolol were well tolerated and neither drug had any significant effects on plasma lipids or lipoproteins. It is concluded that once-daily amlodipine is as effective and well tolerated as atenolol in reducing BP in patients with mildmoderate hypertension