Background
It has been suggested that antihypertensive drug therapy is attributable to the lower
blood pressure variability, we investigated the effects of 4 classes of antihypertensives
on the blood pressure variability; in addition, we also compared the effects among
4 calcium channel blockers.
Methods
We measured the 24-hour blood pressure variability in 309 patients with a history
of cerebrovascular disease treated with angiotensin-converting enzyme inhibitor, angiotensin
receptor blocker, β blocker, or calcium channel blocker.
Results
The daytime blood pressure variability treated with β blockers (14.3 ± 3.1) was higher
than that treated with an angiotensin receptor blockers (11.5 ± 3.1) or calcium channel
blockers (12.6 ± 3.4) in patients with cerebrovascular disease (P < .05). In the analysis of the patient distribution of blood pressure variability,
patients receiving β blockers occurred more frequently in the higher blood pressure
variability (P = .0023). Treatment with angiotensin receptor blockers and cilnidipine, which blocks
N-type calcium channels, was shown to be more frequently associated with the lower
blood pressure variability (P = .0202 and .0467). The mean blood pressure of patients grouped by distribution of
blood pressure variability was found to be independent to blood pressure variability,
for any of the antihypertensive drugs or calcium channel blockers examined.
Conclusions
From the results, it is suggested that angiotensin receptor blocker and calcium channel
blockers rather than β blockers may be more favorable for blood pressure management
in patients with cerebrovascular disease. Among the calcium channel blockers, cilnidipine
may be more favorable than other calcium channel blockers.
Key Words
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Article info
Publication history
Published online: May 13, 2015
Accepted:
April 16,
2015
Received in revised form:
April 15,
2015
Received:
February 28,
2015
Footnotes
R.N. and S.K. are equal first authors.
No potential conflicts of interest are disclosed.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.04.023
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
