Effects Of Lercanidipine Hydrochloride Versus Felodipine Sustained-release On Blood Pressure Variability In Mild-to-moderate Primary Hypertensives

Objective:To compare the effects of lercanidipine hydrochloride and felodipine sustained-release on hourly and day-to-day blood pressure variability in mild-to-moderate primary hypertensives.Methods:This is a sub-study of a multicenter,randomized,open-label,parallel group and active controlled clinical study:lercanidipine hydrochloride versus felodipine sustained-release for mild-to-moderate hypertension(National Clinical Trial:NCT01520285).Mild-to-moderate hypertensives were randomized to lercanidipine group or felodipine group.Patients accepted lecadipine 10mg/d or felodipine 5mg/d treatment for 6 weeks.Patients were asked to record home blood pressure 3 times in the morning and 3 times in the evening everyday since 1 week before randomization to 6 weeks after treatment.Ambulatory blood pressure monitoring(ABPM)were recorded at baseline and 6 weeks.The hourly blood pressure variability were defined as SD of average hourly blood pressure measured by ABPM.The day-to-day blood pressure variability was defined as the SD of the daily BP average(average of six readings)of seven consecutive days measured by HBPM.Results:A total of 186 patients were included in this study(89 in lercanidipine group and 97 in felodipine group).After 6 weeks,hourly diastolic blood pressure(DBP)variability measured by ABPM in both lercanidipine and felodipine groups significantly decreased compared with baseline(P<0.05).Diastolic blood pressure variability in lercanidipine group was significantly lower than in felodipine group(P<0.05),while there was no significant difference in decrease of DBP variability in both groups after adjusted by baseline(P=0.178).The wSD of SBP and DBP in both groups decreased significantly compared with baseline after treatment,and there was no inter-group difference.Day-to-day SBP and DBP variability measured by HBPM decreased significantly after 6 weeks treatment,and there was no significant difference between groups.The decrease of day-to-day SBP and DBP variability had no significant difference in both groups after adjusted by baseline.SBP,DBP and HR measured in office,by ABPM and HBPM were significantly correlated with each other at baseline and during treatment.At baseline,SBP measured in office>measured by HBPM>measured by ABPM.Conclusion:Treatment with lercanidipine and felodipine both resulted in reduction of hourly and day-to-day BPV.There was no significant inter-group difference in reduction of BPV between the groups.Lercanidipine is an effective antihypertensive drug in improving BPV.