Amlodipine versus atenolol in essential hypertension

• Published in: The American journal of cardiology Vol. 73; no. 3; pp. A50 - A54
• Main Authors: Frishman, William H., Brobyn, Richard, Brown, Ronald D., Johnson, Brian F., Reeves, Robert L., Wombolt, Duane G.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 27.01.1994; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Amlodipine - administration & dosage; Amlodipine - adverse effects; Atenolol - administration & dosage; Atenolol - adverse effects; Blood Pressure - drug effects; Double-Blind Method; Drug Administration Schedule; Drug therapy; Edema - chemically induced; Fatigue - chemically induced; Female; Headache - chemically induced; Heart Rate - drug effects; Humans; Hypertension; Hypertension - drug therapy; Hypertension - physiopathology; Male; Medical research; Middle Aged
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(94)90275-5

The efficacy and safety of amlodipine (2.5–10 mg) once daily was compared with atenolol (50–100 mg) once daily in patients with mild-to-moderate essential hypertension in a randomized, doubleblind, parallel, placebo-controlled study. A total of 125 patients were randomly allocated at the end of a 4-week run-in placebo period to 8 weeks of double-blind treatment with amlodipine (n = 41), atenolol (n = 43), or placebo (n = 41). The placebo group had small mean changes in supine and standing blood pressure compared with baseline. The mean blood pressure changes from baseline 24 hours postdose in the amlodipine group (mean daily dose 8.8 mg) were −12.8/−10.1 mm Hg for supine blood pressure and −11.5/−9.8 mm Hg for standing blood pressure (p < 0.001 compared with placebo), and for the atenolol group (mean daily dose 83.7 mg) the changes were −11.3/−11.7 mm Hg for supine blood pressure and −13.3/−12.3 mm Hg for standing blood pressure (p < 0.001 compared with placebo). There were no statistically significant blood pressure differences between active treatments. The responder rates for amlodipine, atenolol, and placebo were 61.1, 64.9, and 11.1%, respectively. The blood pressure values taken over the 24-hour period at final visit revealed that amlodipine and atenolol maintained the supine blood pressure ≤ 140/90 mm Hg throughout the period of observation; the corresponding time-effect curve for the placebo group was clearly in the hypertensive range. Heart rate was significantly lowered by atenolol only. Both amlodipine and atenolol were well tolerated. Only 1 patient was withdrawn due to adverse effects (development of peripheral edema, arthralgia and fatigue) related to amlodipine. This study demonstrates that once-daily therapy with amlodipine or atenolol was well tolerated in patients with mild-to-moderate essential hypertension and provided control of blood pressure throughout the 24-hour dosing interval.