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

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 (ba PWV ) 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 ba PWV . 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 .