title: Effect of chlorthalidone, amlodipine, and lisinopril on visit-to-visit variability of blood pressure: results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.
abstract: Few randomized trials have compared visit-to-visit variability (VVV) of systolic blood pressure (SBP) across drug classes. The authors compared VVV of SBP among 24,004 participants randomized to chlorthalidone, amlodipine, or lisinopril in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). VVV of SBP was calculated across 5 to 7 visits occurring 6 to 28 months following randomization. The standard deviation (SD) of SBP was 10.6 (SD=5.0), 10.5 (SD=4.9), and 12.2 (SD=5.8) for participants randomized to chlorthalidone, amlodipine, and lisinopril, respectively. After multivariable adjustment including mean SBP across visits and compared with participants randomized to chlorthalidone, participants randomized to amlodipine had a 0.36 (standard error [SE]: 0.07) lower SD of SBP and participants randomized to lisinopril had a 0.77 (SE=0.08) higher SD of SBP. Results were consistent using other VVV of SBP metrics. These data suggest chlorthalidone and amlodipine are associated with lower VVV of SBP than lisinopril.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.forename: Emily B
authors.initials: EB
authors.lastname: Levitan
authors.forename: Amy I
authors.initials: AI
authors.lastname: Lynch
authors.forename: Lara M
authors.initials: LM
authors.lastname: Simpson
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Whittle
authors.forename: Barry R
authors.initials: BR
authors.lastname: Davis
authors.forename: John B
authors.initials: JB
authors.lastname: Kostis
authors.forename: Paul K
authors.initials: PK
authors.lastname: Whelton
authors.forename: Suzanne
authors.initials: S
authors.lastname: Oparil
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology / Q000517:prevention & control*; D000368:Aged; D017311:Amlodipine / Q000008:administration & dosage*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D002752:Chlorthalidone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D017706:Lisinopril / Q000008:administration & dosage*; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D000960:Hypolipidemic Agents; D017311:Amlodipine; D017706:Lisinopril; D002752:Chlorthalidone
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