Peripheral and central blood pressure responses of combination
aliskiren/hydrochlorothiazide and amlodipine monotherapy in African American
patients with stage 2 hypertension: the ATLAAST trial.
Author(s): Ferdinand KC, Pool J, Weitzman R, Purkayastha D, Townsend R.
Affiliation(s): Cardiology Division, Emory University, Atlanta, GA 30349, USA.
kferdinand@abcardio.org
Publication date & source: 2011, J Clin Hypertens (Greenwich). , 13(5):366-75
Efficacy of antihypertensive agents on central blood pressure (BP) in African
Americans is not well studied. The authors report on an 8-week double-blind,
randomized study of African American patients with stage 2 hypertension that
compared brachial and central BP responses (substudy of 53 patients) to
combination aliskiren/hydrochlorthiazide (HCTZ) and amlodipine monotherapy.
Following a 1- to 4-week washout, initial therapy was aliskiren/HCTZ 150/12.5 mg
(n=166) or amlodipine 5 mg (n=166) for 1 week, forced-titrated to aliskiren/HCTZ
300/25 mg or amlodipine 10 mg for 7 weeks. Mean seated systolic BP reductions
from baseline was similar with both treatments (-28.6 mm Hg with aliskiren/HCTZ
vs -28.2 mm Hg with amlodipine). In the substudy, significantly greater
reductions in central systolic BP was observed with aliskiren/HCTZ vs amlodipine
(-30.1 mm Hg vs -21.2; P=.031), although 24-hour mean ambulatory BP reductions
between the two groups were similar. Central pressure is considered an important
risk factor in African Americans, and these findings may suggest a new treatment
option for these patients.
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