Key result
Calcium channel blocker monotherapy was associated with significantly elevated ambulatory BP and less ambulatory control compared to thiazides (P<.01).
Why the study?
Do different antihypertensive monotherapies improve ambulatory blood pressure control in hypertensive patients?
Observational (n=22,617)
Yes
Do different antihypertensive monotherapies improve ambulatory blood pressure control in hypertensive patients?
p-value: p=<.01
Significant differences exist in ambulatory BP control among different antihypertensive drug classes and specific agents within classes, which can guide drug selection when BP reduction is the primary objective.
May not support CCB monotherapy for ambulatory goals; leaves open class comparisons in randomized trials.
The authors investigated the differences in office and ambulatory blood pressure (BP) among major antihypertensive drug classes and among frequently used drugs in each class in 22,617 patients treated with monotherapy from the Spanish ABPM Registry. Using thiazides as the reference group, patients treated with calcium channel blockers have significantly (P<.01) elevated ambulatory BP and less ambulatory control after adjusting for confounders. Inside each class, no significant differences were observed among thiazides or angiotensin receptor blockers. Atenolol and bisoprolol among β-blockers, amlodipine among calcium channel blockers, and lisinopril and enalapril among angiotensin-converting enzyme inhibitors exhibited lower ambulatory BP and better control than other agents. Differences exist among antihypertensive drug classes and among different compounds in each class with respect to ambulatory BP control. This can help physicians choose among drug classes and among compounds in each class if BP reduction is the main objective of treatment.
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Sierra et al. (2015) conducted an observational in Hypertension (n=22,617). Antihypertensive monotherapy vs. Thiazides was evaluated on Ambulatory blood pressure and ambulatory control (p=<.01). Calcium channel blocker monotherapy was associated with significantly elevated ambulatory BP and less ambulatory control compared to thiazides (P<.01).
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