Open AccessEffect of Chlorthalidone, Amlodipine, and Lisinopril on Visit‐to‐Visit Variability of Blood Pressure: Results From the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial
Author(s) -
Muntner Paul,
Levitan Emily B.,
Lynch Amy I.,
Simpson Lara M.,
Whittle Jeffrey,
Davis Barry R.,
Kostis John B.,
Whelton Paul K.,
Oparil Suzanne
Publication year - 2014
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12290
Subject(s) - chlorthalidone , lisinopril , amlodipine , medicine , blood pressure , randomized controlled trial , randomization , cardiology , angiotensin converting enzyme
Few randomized trials have compared visit‐to‐visit variability ( VVV ) of systolic blood pressure ( SBP ) across drug classes. The authors compared VVV of SBP among 24,004 participants randomized to chlorthalidone, amlodipine, or lisinopril in the Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial ( ALLHAT ). VVV of SBP was calculated across 5 to 7 visits occurring 6 to 28 months following randomization. The standard deviation ( SD ) of SBP was 10.6 ( SD =5.0), 10.5 ( SD =4.9), and 12.2 ( SD =5.8) for participants randomized to chlorthalidone, amlodipine, and lisinopril, respectively. After multivariable adjustment including mean SBP across visits and compared with participants randomized to chlorthalidone, participants randomized to amlodipine had a 0.36 (standard error [ SE ]: 0.07) lower SD of SBP and participants randomized to lisinopril had a 0.77 ( SE =0.08) higher SD of SBP . Results were consistent using other VVV of SBP metrics. These data suggest chlorthalidone and amlodipine are associated with lower VVV of SBP than lisinopril.