Peripheral and central blood pressure responses of combination aliskiren/hydrochlorothiazide and amlodipine monotherapy in African American patients with stage 2 hypertension: the ATLAAST trial

J Clin Hypertens (Greenwich). 2011 May;13(5):366-75. doi: 10.1111/j.1751-7176.2010.00416.x. Epub 2011 Jan 18.

Abstract

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.

Trial registration: ClinicalTrials.gov NCT00739596.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • African Americans*
  • Amides / adverse effects
  • Amides / pharmacology
  • Amides / therapeutic use*
  • Amlodipine / adverse effects
  • Amlodipine / pharmacology
  • Amlodipine / therapeutic use*
  • Antihypertensive Agents / adverse effects
  • Antihypertensive Agents / pharmacology
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure / drug effects
  • Blood Pressure / physiology*
  • Brachial Artery / physiology
  • Diarrhea / chemically induced
  • Diarrhea / epidemiology
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Fumarates / adverse effects
  • Fumarates / pharmacology
  • Fumarates / therapeutic use*
  • Headache / chemically induced
  • Headache / epidemiology
  • Humans
  • Hydrochlorothiazide / adverse effects
  • Hydrochlorothiazide / pharmacology
  • Hydrochlorothiazide / therapeutic use*
  • Hypertension / drug therapy*
  • Hypertension / ethnology*
  • Hypertension / physiopathology
  • Incidence
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Amides
  • Antihypertensive Agents
  • Fumarates
  • Hydrochlorothiazide
  • Amlodipine
  • aliskiren

Associated data

  • ClinicalTrials.gov/NCT00739596