Key result
Lisinopril and valsartan regimens show greater pulse pressure reduction than indapamide, atenolol, and amlodipine.
Why the study?
The effect of different antihypertensive agents on pulse pressure in patients with newly diagnosed stage I hypertension was investigated to understand comparative efficacy.
Do different antihypertensive agents have varying effects on pulse pressure reduction in patients with newly diagnosed stage I hypertension?
Do different antihypertensive agents have varying effects on pulse pressure reduction in patients with newly diagnosed stage I hypertension?
ACE inhibitors and ARBs, alone or in combination with hydrochlorothiazide, provide greater pulse pressure reduction than amlodipine, indapamide, or atenolol in newly diagnosed stage I hypertension.
May inform initial agent selection in stage I hypertension; supports class differences but leaves open outcome impact and requires RCTs.
In this study, we investigated the effect of different antihypertensive agents on pulse pressure (PP). The study was designed in a prospective manner and patients were sequentially allocated to one of the seven different therapy groups, according to the order of enrollment (every first patient to group I, every second patient to group II, and etc). Patients in group I received 10 mg of lisinopril, in group II 10/6.25 mg of lisinopril/hydrochlorothiazide, in group III 80 mg of valsartan, in group IV 80/6.25 mg of valsartan/hydrochlorothiazide, in group V 5 mg of amlodipine, in group VI 1.25 mg of indapamide, and finally those in group VII received 50 mg of atenolol. The reduction in PP was more significant in patients receiving lisinopril, lisinopril hydrochlorothiazide, valsartan, and valsartan hydrochlorothiazide, when compared with patients receiving indapamide, atenolol, and amlodipine (P < 0.05 for each group). Factors such as age, gender, and body mass index were not found to significantly influence the effectiveness of antihypertensive agents on PP. The reduction in PP was more apparent with lisinopril, lisinopril hydrochlorothiazide, valsartan, and valsartan hydrochlorothiazide in diabetic patients, when compared with those without diabetes (P < 0.001, P < 0.05). And also patients on therapy with 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors had a greater reduction in PP with lisinopril, lisinopril hydrochlorothiazide, valsartan, and valsartan hydrochlorothiazide (P < 0.001, P < 0.05).
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Alıcı et al. (2009) studied Newly Diagnosed Stage I Hypertension. Lisinopril, lisinopril/hydrochlorothiazide, valsartan, or valsartan/hydrochlorothiazide vs. Amlodipine (5 mg), indapamide (1.25 mg), or atenolol (50 mg) was evaluated on Reduction in pulse pressure (PP) (p=<0.05). Lisinopril, lisinopril/hydrochlorothiazide, valsartan, and valsartan/hydrochlorothiazide reduced pulse pressure more significantly than indapamide, atenolol, and amlodipine (P<0.05).
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