Doxazosin, amlodipine, enalapril, and bendrofluazide were equally effective at controlling 24-hour blood pressure, while doxazosin and amlodipine showed greater reductions in total cholesterol.
RCT (n=110)
Double-blind
Parallel group
Yes
Do doxazosin, amlodipine, enalapril, and bendrofluazide effectively maintain 24-hour blood pressure control in patients with mild to moderate hypertension?
Four common antihypertensives provided equal 24-hour blood pressure control, but doxazosin and amlodipine offered additional lipid-lowering benefits.
This multicenter, randomized, double-blind, parallel group study was undertaken to determine the effectiveness of selected antihypertensives (doxazosin, amlodipine, enalapril, and bendrofluazide) in maintaining 24-hour control of blood pressure (BP). The predictive value of ambulatory (A)BP versus clinic (C)BP measurements as a method for detecting patients with hypertension was also evaluated. A total of 204 patients were screened and of these 110 were diagnosed as mild to moderately hypertensive with clinic diastolic BP 100-110 mm Hg (> or =95 mm Hg in patients with coronary heart disease risk factors). The 4 antihypertensives were all equally effective at controlling BP over 24 h, as shown by 24-hour ABP measurements. The incidence of adverse events was similar for all 4 treatment groups; headache was the most common event, being reported by 22 patients (20%). There was a clinically relevant reduction in total cholesterol for the doxazosin (-15.4 mg/dl) and amlodipine (-11.6 mg/dl) treatment groups in comparison with enalapril and bendrofluazide. Our results from ABP measurements suggest that the antihypertensives studied are effective first-line therapy in the regulation of hypertension and that ABP is a reproducible measure. ABP may also be useful in identifying patients with various types of high BP, for instance those with 'white coat' hypertension, enabling more accurate screening and diagnosis.
David Ebbs (2001) conducted an RCT in Hypertension (n=110). Doxazosin, amlodipine, enalapril, and bendrofluazide vs. Active comparators (each other) was evaluated on 24-hour control of blood pressure. Doxazosin, amlodipine, enalapril, and bendrofluazide were equally effective at controlling 24-hour blood pressure, while doxazosin and amlodipine showed greater reductions in total cholesterol.