title: Influence of a single dose of 20 mg tadalafil, a phosphodiesterase 5 inhibitor, on ambulatory blood pressure in subjects with hypertension.
abstract: OBJECTIVE
  To test the non-inferiority of a single dose of tadalafil 20 mg compared with placebo with respect to 26-h mean ambulatory systolic and diastolic blood pressure in treated and untreated hypertensive subjects.
  
  
  METHODS
  A multicentre, randomized, double-blind, placebo-controlled crossover study in 114 subjects with hypertension (36 subjects on no therapy with daytime mean ambulatory blood pressure >/= 140/85 mmHg; 38 subjects on two to four classes of antihypertensive agents with daytime mean ambulatory blood pressure >/=140/85 mmHg and 40 subjects on two to four classes of antihypertensive agents with ambulatory blood pressure < 140/85 mmHg).
  
  
  RESULTS
  Overall tadalafil reduced mean ambulatory blood pressure monitor systolic and diastolic blood pressure by 4.8 mmHg [95% confidence interval (Cl) 3.7, 5.9; P < 0.01] and 2.9 mmHg (95% CI 1.9, 3.6; P < 0.01), respectively, compared with placebo. In hypertensive subjects with uncontrolled blood pressure on two to four classes of antihypertensive agents (n = 36) tadalafil reduced mean ABPM systolic and diastolic blood pressure by 7.5 mmHg (95% CI 5.4, 9.6; P < 0.01) and 4.3 mmHg (95% CI 6.1, 8.9; P < 0.01) compared with placebo.
  
  
  CONCLUSIONS
  In patients with uncontrolled hypertension on multiple agents the addition of tadalafil 20 mg lowered mean 26-h blood pressure.
authors.affiliation: Department of Medicine, Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, Dundee, UK. d.patterson@dundee.ac.uk
authors.forename: Dean
authors.initials: D
authors.lastname: Patterson
authors.forename: Gordon T
authors.initials: GT
authors.lastname: McInnes
authors.forename: John
authors.initials: J
authors.lastname: Webster
authors.forename: Malcolm M
authors.initials: MM
authors.lastname: Mitchell
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Macdonald
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects*; D002243:Carbolines / Q000008:administration & dosage* / Q000009:adverse effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010726:Phosphodiesterase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000068581:Tadalafil; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D002243:Carbolines; D010726:Phosphodiesterase Inhibitors; D000068581:Tadalafil