Blood Pressure Variability and Smoothness Index after 6 Antihypertensive Drugs

Abstract

Background The aim of the study was to recognize, if long-acting hypertensive drugs reduce the blood pressure variability, in comparison with placebo.
Material and methods The study group consisted of 100 patients with mild or moderate essential hypertension. Ambulatory blood pressure monitoring (ABPM) was performed after placebo and after six drugs: bisoprolol — 5 mg (n = 19), perindopril — 4 mg (n = 15), verapamil 120–240 mg (n = 21), nitrendipine — 10 mg (n = 17), candesartan — 16 mg (n = 15), and losartan — 50 mg (n = 13). On the base of ABPM it was calculated: the mean 24-h arterial blood pressure (BP) reduction, the trough/peak index, and the smoothness index (method of [14]), corrected in relation to placebo (Slc).
Results The reduction of the mean 24-h BP was significant after 5 drugs (except losartan). The highest reduction was present after perindopril. The trough/peak index after six drugs was ł 50%, in them after bisoprolol and perindopril >60%. The trend of BP variability reduction (calculated from SD) was observed after all drugs. After bisoprolol and candesartan the BP variability decreased statistical significantly. The smoothness index after six drugs varied from 0,24 to 1,36.
Conclusion On the base of global analyse of ABPM parameters, it was concluded that bisoprolol, candesartan and perindopril reduced variability of diastolic blood pressure in the most significant degree.