The Effects Of Amlodipine Besylate Tablets And Nifedipine CR On Morning Blood Pressure And Blood Pressure Variability Inpatients With Primary Morning Hypertension

Objects: To comparatively analyze the effects of amlodipine besylate tablets and nifedipine CR tablets on morning blood pressure(MBP) and blood pressure variability in patients with primary morning hypertension(MH).Methods: Patients between 20~75 years, with grades 1-2 essential hypertension which untreated or having stopped taking blood pressure medicine for more than 1 week were selected from cardiovascular department. Patients with morning hypertension(morning SBP≥135mm Hg or/and morning DBP≥85mm Hg) were screened out. In total of 60 patients were enrolled in the study and randomly divided into two groups, One group was given amlodipine besylate tablets 5mg orally qd; The other group was given nifedipine CR tablets 30 mg orally qd, during 6:00am to 8:00am. Treatment course lasted for 5weeks. Home blood pressure was measured everyday and office blood pressure was monitored at 2 and 5weeks after treatment. Analyze the changes of office blood pressure, home blood pressure and blood pressure variability(BPV), heart rate(HR) and heart rate variability(HRV) in two groups.Results: 1. 60 patients were enrolled in the study, but 3 of them dropped out, of which 2 cases lost to follow-up, 1 case switched to other drugs. Totally 57 cases adhered to medication and the follow-up on schedule, among those, 29 cases for amlodipine besylate tablets group and 28 cases for nifedipine CR tablets group. Two groups’ baseline datas have the homogeneity.2. Office blood pressure(OBP): No significant difference of the control rate of OBP was found between amlodipine besylate tablets group and nifedipine CR tablets group(65.52% vs 64.29%, p>0.05). Obvious antihypertensive effects were sawn after 2 weeks of treatment in both groups(p<0.05). After 5 weeks of treatment, the decrease range of office blood pressure in two groups was resemble(19.34±11.75/11.69±7.30vs 19.29±13.63/12.57±8.17 mm Hg, p>0.05).3. Home blood pressure(HBP):The control rate of morning BP between amlodipine besylate tablets group and nifedipine CR tablets group was parallel(75.86% vs 82.14%, p>0.05). After 2 weeks of treatment, the MBP of both groups were significantly decreased(p<0.05). The decrease rate of SBP and DBP were 71.17% and 64.20% in amlodipine besylate tablets group, 84.63% and 79.18% in nifedipine CR tablets group. No significant difference in the decrease range of MBP after 5 weeks was found in two groups(14.81±7.43/9.20±7.50 vs 16.01±7.44/10.23±3.92 mm Hg, p>0.05). The control rate of evening BP was alike between two groups(79.31% vs 82.14%, p>0.05). After 2 weeks of treatment, the evening BP of both groups were significantly decreased(p<0.05). No significant difference was found in the decrease range of blood pressure after 5 weeks of treatment(14.53±8.49/7.95±5.70 vs 14.17±8.97/8.49±4.59 mm Hg, p>0.05). Similarity, There was no significant difference in the control rate of whole-day BP between amlodipine besylate tablets group and nifedipine CR tablets group(75.86% vs 82.14%, p>0.05).4. After 5 weeks of treatment, the morning systolic diastolic blood pressure variability(SBPV) in amlodipine besylate tablets group was significantly decreased(5.86±2.17 vs 7.93±3.97 mm Hg, p<0.05). However, SBPV in nifedipine CR tablets group had no difference(6.82±3.05 mm Hg vs 7.10±2.95 mm Hg, p>0.05).5. After 5 weeks of treatment, no matter office heart rate or family self-test heart rate decreased in amlodipine besylate tablets group, conversely, both office heart rate and family self-test heart rate increased in nifedipine CR tablets group, No significant difference was found in heart rate or heart rate variability(HRV) before and after treatment in both groups. Adverse events incidence rate accounted for 3.4 % in amlodipine besylate tablets group and 7.1% in nifedipine CR tablets group.Conclusion: Amlodipine besylate tablets and nifedipine CR tablets can effectively control the OBP and HBP. Both drugs can obtain obvious anti-hypertensive effects after 2 weeks of treatment. Amlodipine besylate tablets Can better improve the morning systolic blood pressure variability(SBPV).