Differences between amlodipine and lisinopril in control of clinic and twenty-four hour ambulatory blood pressures

The anti-hypertensive efficacy of once-daily amlodipine (up to 10 mg) and lisinopril (up to 20 mg) were compared in terms of clinic and ambulatory blood pressure (BP) control, in an observer-blind, two-period crossover study. Following a 4-week placebo run-in period, patients underwent two active treatment phases each lasting 12 weeks and separated by a 4-week washout period. Sixty patients with a supine diastolic BP between 90 and 120 mm Hg were included, irrespective of whether or not they had received previous anti-hypertensive medication. Amlodipine reduced supine systolic and diastolic clinic BP significantly more than lisinopril (-20+/-2/-14+/-1 vs -11 3/-7+/-1 mm Hg; P=0.02/ P=0.001) 24 h post-dose. Clinic standing diastolic BP was also significantly reduced with amlodipine compared with lisinopril (P=0.05). Both drugs produced control of mean ambulatory BP relative to baseline over 24 h. Amlodipine showed more consistent control of BP over the 24-h period in contrast to lisinopril which exerted its greatest effect during the daytime.