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John M. Dopp, Michael E. Ernst, Kevin C. Dellsperger, Bradley G. Phillips, P-267: Comparison of amlodipine and felodipine on 24-hour ambulatory blood pressure in hypertensive patients, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 118A, https://doi.org/10.1016/S0895-7061(01)02121-5
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Abstract
Amlodipine and felodipine are often used interchangeably on hospital formularies for the treatment of hypertension. Although these agents possess similar potencies and side effect profiles, direct comparisons are limited. In a randomized, investigator-blinded fashion, we evaluated 63 mild to moderate hypertensive patients (sitting systolic BP 140 to 179 mmHg or sitting diastolic BP 90 to 109 mmHg) during 8 weeks of amlodipine or felodipine therapy. Study drug therapy was started at 5mg daily and increased to 10 mg daily at 2 week intervals if BP was not controlled. Sitting, 24-hour ambulatory blood pressure (ABP) and heart rate (HR) were evaluated at baseline, 1, 4 and at 8 weeks of therapy. Of the 63 patients enrolled, 50 (age 56±12yrs) completed 8 weeks of therapy. Patients (n=24) randomized to amlodipine had a sitting BP of 151±12/93±8 mmHg prior to randomization. In those randomized to felodipine (n=26), sitting BP was 150±9/93±10 mmHg. Resting HR and 24-hour ABP were similar in both groups. Mean 24-hour ABP was 104±7 mmHg at baseline and decreased at 1, 4, and 8 weeks of amlodipine to 103±7, 100±7 and 95±6 mmHg, respectively (p<0.05). Felodipine decreased mean 24-hour ABP from 103±8 mmHg to 95±11, 94±7, and 96±6 mmHg at 1, 4 and 8 weeks, respectively (p<0.05). Felodipine produced a greater reduction in mean 24-hour ABP at 1 week compared to amlodipine (p<0.05) but were similar at 8 weeks of therapy. There were no differences in daytime or nighttime ABP between amlodipine and felodipine at 8 weeks of therapy. The mean doses of amlodipine and felodipine at the end of the study were 8±2mg and 7±2mg, respectively. Side effects were similar in both groups. Felodipine decreased BP sooner than amlodipine and controlled BP over 8 weeks of therapy. Amlodipine and felodipine are similar antihypertensive agents and have comparable BP profiles during the day and night following 8 weeks of therapy in patients with mild to moderate hypertension.
