Differing Effects of Aliskiren/Amlodipine Combination and High‐Dose Amlodipine Monotherapy on Ambulatory Blood Pressure and Target Organ Protection

Abstract

The aim of this study was to compare an aliskiren/amlodipine combination with high‐dose amlodipine monotherapy on ambulatory blood pressure monitoring (ABPM) and organ protection. The study was a prospective, randomized, multicenter, open‐label trial in elderly essential hypertensive patients. A total of 105 patients with clinic BP (CBP) ≥140/90 mm Hg with amlodipine 5 mg were randomly allocated to aliskiren (150–300 mg)/amlodipine (5 mg) (ALI/AML group, n=53) or high‐dose amlodipine (10 mg) (h‐dAML group, n=52) and treated for 16 weeks. Each patient's CBP, ABPM, urine albumin‐to‐creatinine ratio (UACR), and brachial‐ankle pulse wave velocity (baPWV) were measured at baseline and at the end of the study. The ALI/AML and h‐dAML groups showed similarly reduced mean 24‐hour SBP, daytime SBP, nighttime SBP, and baPWV. However, UACR reduction was significantly greater in the ALI/AML group (P=.02). ALI/AML was significantly less effective in reducing early‐morning BP (P=.002) and morning BP surge (P=.001) compared with h‐dAML.

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