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Comparison of Blood Pressure Variability Between Losartan and Amlodipine in Essential Hypertension (COMPAS-BPV)

Jun-Won Lee1, Eunhee Choi2, Jung-Woo Son1

  • 1Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Republic of Korea.

American Journal of Hypertension
|April 9, 2020
PubMed

Insights

Amlodipine and losartan showed similar effects on systolic blood pressure variability (BPV). However, amlodipine may be more effective in reducing overall BPV in essential hypertension patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Established antihypertensive therapies using renin-angiotensin system blockers and calcium channel blockers do not yet have a defined strategy for targeting blood pressure variability (BPV).
  • Essential hypertensive patients require comparative studies on the efficacy of different antihypertensive agents in managing BPV.

Purpose of the Study:

  • To compare the efficacy of losartan (a renin-angiotensin system blocker) and amlodipine (a calcium channel blocker) in reducing blood pressure variability (BPV) and systolic blood pressure (SBP).

Main Methods:

  • A randomized trial involving essential hypertensive patients assigned to either losartan 50 mg or amlodipine 5 mg.
  • Medications were uptitrated, with hydrochlorothiazide added as needed over a 6-month period.
  • Primary endpoint: office visit-to-visit standard deviation (SD) of SBP; Secondary endpoints: average real variability (ARV), office SBP, and home SBP.

Main Results:

  • The office visit-to-visit SD of SBP was comparable between the losartan and amlodipine groups.
  • The losartan group exhibited significantly higher office visit-to-visit ARV of SBP and evening day-to-day home BPV indexes.
  • While absolute SBP reduction was similar, office mean SBP at 6 months was higher in the losartan group.

Conclusions:

  • Both losartan and amlodipine demonstrated similar effects on reducing office visit-to-visit SD of SBP.
  • Amlodipine may offer superior BPV reduction compared to losartan, as indicated by higher ARV and home BPV indexes in the losartan group.
  • Amlodipine could be a preferred choice for managing BPV in essential hypertensive patients.
Abstract

Keywords:
amlodipineblood pressureessential hypertensionhypertensionlosartan

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