title: Effects of Amlodipine and Valsartan on Blood Pressure Variability and Pulse Wave Velocity in Hypertensive Patients.
abstract: OBJECTIVE
  Antihypertensive therapy is effective to control blood pressure (BP) and to prevent cardiovascular events, but the further treatment strategies for patients who cannot achieve goal BP with low-dose monotherapy is still under dispute. Our study investigates the effects of high-dose amlodipine and valsartan and their low-dose combination on blood pressure variability (BPV) and pulse wave velocity (PWV) to provide references for clinical medication.
  
  
  METHODS
  This study was a prospective, randomized, parallel, case-controlled trial performed in a medical center. A total of 134 outpatients newly diagnosed with essential hypertension or receiving low-dose monotherapy were enrolled and 119 completed the trial. They were randomized into amlodipine 10mg group (n = 40), valsartan 160mg group (n = 38) and amlodipine 5mg + valsartan 80mg (n = 41) in a 1:1:1 allocation ratio for a 10-week treatment. Demographic data and laboratory indicators were collected at the randomization and 10 weeks after the treatment. The 24-hour ambulatory BP and brachial-ankle PWV were also monitored.
  
  
  RESULTS
  All therapies reduced systolic and diastolic BP (P < 0.05). The 24-hour systolic BPV was significantly decreased in amlodipine and combination groups (3.55 ± 2.57, 4.11 ± 2.20 versus 2.23 ± 2.54mmHg, P < 0.05). The effects on diastolic BPV differed between different treatments. PWV was lowered by 3 antihypertensive schemes; the degree of which from strongest to weakest were valsartan, combination and amlodipine (228.87 ± 60.41 versus 152.49 ± 49.25 versus 99.35 ± 35.57cm/second, P < 0.01).
  
  
  CONCLUSIONS
  All further strategies can effectively control BP. The combination treatment reduces both BPV and PWV noticeably, whereas double-dose amlodipine achieves the greatest BPV decrease and valsartan is best in controlling PWV.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Rufeng
authors.initials: R
authors.lastname: Shi
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Di
authors.initials: D
authors.lastname: Shi
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: xiaopingchen11@126.com.
authors.forename: Xiaoping
authors.initials: X
authors.lastname: Chen
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004359:Drug Therapy, Combination; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D000068756:Valsartan / Q000627:therapeutic use*
chemical_list: D000959:Antihypertensive Agents; D017311:Amlodipine; D000068756:Valsartan
keywords: Blood pressure variability; Hypertension; Pulse wave velocity