Related Experiment Videos
Effect of amlodipine on systolic blood pressure
Cindy B Levine1, Kyle R Fahrbach, Diana Frame
1MetaWorks Inc., Medford, Massachusetts 02155, USA.
Insights
Amlodipine effectively lowers systolic blood pressure (SBP) in various patient groups, including the elderly and those with isolated systolic hypertension. This review supports amlodipine
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Systolic hypertension is prevalent in individuals over 60 and is a significant cardiovascular disease risk factor.
- Decreased arterial compliance contributes to systolic hypertension.
- Controlling systolic blood pressure (SBP) is crucial, often more so than diastolic blood pressure (DBP).
Purpose of the Study:
- To systematically review the literature on amlodipine's effectiveness in reducing SBP.
- To assess amlodipine's efficacy across diverse patient subgroups and clinical scenarios.
- To evaluate amlodipine's role in managing inadequately controlled SBP.
Main Methods:
- Systematic literature review of studies published between 1980 and 2001.
- Inclusion of parallel-group, randomized, controlled trials with amlodipine monotherapy arms.
- Analysis of 85 studies involving over 5000 patients with baseline hypertension.
Main Results:
- Amlodipine monotherapy resulted in a mean SBP reduction of 17.5 mm Hg.
- Amlodipine demonstrated greater efficacy in elderly patients (>=60 years) and those with isolated systolic hypertension.
- Dose titration was employed in most amlodipine treatment arms, with a median daily dose of 5 mg.
Conclusions:
- Amlodipine monotherapy is effective for reducing SBP.
- Amlodipine is a viable option for patients with inadequately controlled SBP.
- Consideration of amlodipine is warranted in hypertension management protocols.
Background:
Systolic hypertension is the most common form of hypertension, particularly in people aged >60 years. Caused by decreased compliance of large arteries, systolic hypertension is an independent risk factor for cardiovascular disease. Recent studies have demonstrated that it is more important to control systolic blood pressure (SBP) than diastolic blood pressure (DBP).
Objective:
The objective of this study was to perform a systematic literature review to examine the effectiveness of amlodipine in lowering SBP in a variety of patient subgroups and clinical settings.
Methods:
The literature review methodology included identifying, selecting, appraising, extracting, and synthesizing primary research studies. Following an a priori protocol, published literature was searched from 1980 to 2001 using 3 electronic databases. A manual review of the reference lists of recent review articles and all accepted studies was performed. Parallel-group, randomized, controlled trials that included at least 10 adults with baseline hypertension (SBP>or=140 mm Hg, DBP>or=90 mm Hg, or both), included at least 1 arm randomized to initial treatment with amlodipine monotherapy, had a minimum treatment duration of 8 weeks, and reported baseline and end-point blood pressure were included.
Results:
Of 696 citations identified, 85 primary studies met all inclusion criteria. Comparable treatment arms were pooled, and weightd mean SBP was calculated. In the amlodipine monotherapy arms, which included >5000 patients, SBP decreased by a mean of 17.5 mm Hg from baseline. The effect of amlodipine in reducing SBP was greater in elderly patients (age>or=60 years) and patients with author-defined isolated systolic hypertension. The dose was titrated to achieve the target blood pressure in 73 of 89 amlodipine treatment arms, whereas 16 treatment arms reported fixed doses. The median daily dose was 5 mg (range, 1.25-15 mg) in both the fixed-dose and dose-titration groups.
Conclusions:
In this review of the published literature, amlodipine monotherapy was effective in reducing SBP. Antihypertensive agents such as amlodipine warrant consideration for the management of patients with inadequately controlled SBP.