Antihypertensive therapy and short-term blood pressure variability
| Autor: | Aina Mateu, Ernest Vinyoles, Manuel Gorostidi, Julian Segura, Luis M. Ruilope, Alejandro de la Sierra |
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| Rok vydání: | 2020 |
| Předmět: |
Drug
medicine.medical_specialty Ambulatory blood pressure Physiology medicine.drug_class media_common.quotation_subject Diastole Blood Pressure Calcium channel blocker 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Internal Medicine medicine Humans 030212 general & internal medicine Amlodipine Antihypertensive drug Antihypertensive Agents media_common business.industry Blood Pressure Monitoring Ambulatory Calcium Channel Blockers Blood pressure Drug class Hypertension Cardiology Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of Hypertension. 39:349-355 |
| ISSN: | 1473-5598 0263-6352 |
| DOI: | 10.1097/hjh.0000000000002618 |
| Popis: | Background and aim Blood pressure variability (BPV) is recognized as a prognostic contributor in hypertension. We aimed to assess differences in short-term BPV in treated hypertensive patients depending on the number, classes, combinations and individual compounds of the antihypertensive treatment. Methods We selected 38 188 treated patients from the Spanish Ambulatory BP Monitoring (ABPM) Registry. SBP and DBP standard deviations (SD) from 24-h, daytime and night-time, weighted SD (WSD), and average real variability (ARV) were calculated through ABPM. They were compared (after adjustment for clinical confounders and BP) depending on the number of antihypertensive drugs, antihypertensive drug classes and compounds (in 13 765 patients on monotherapy), or combinations (in 12 716 patients treated with two drugs and 7888 treated with three drugs). Results Systolic and diastolic BPV significantly increased in patients treated with multiple drugs with respect to monotherapy. Among drug classes, calcium channel blockers, especially amlodipine, and diuretics were associated with lower systolic BPV, including daytime and night-time SD, WSD and ARV, compared with beta blockers, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Likewise, in patients treated with two-drug and three-drug combinations, those which included a calcium channel blocker showed lower BPV in comparison to those without such drug class. Conclusion Treatment with calcium channel blockers, especially amlodipine, and with diuretics is associated with slight, but significant lower values of short-term BPV in comparison to other major drug classes, both in monotherapy and in combination. These results could be helpful when considering BPV reduction as an additional treatment target. |
| Databáze: | OpenAIRE |
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