Randomized comparison of systolic blood pressure variability (COMPASS-BPV) and central blood pressure in essential hypertensive patients treated with a calcium channel blocker (amlodipine) or angiotensin II receptor blocker (losartan)

Jun Won Lee, Eunhee Choi, Ji Hyun Lee, Young Jin Youn, Sung Gyun Ahn, Min Soo Ahn, Jang Young Kim, Seung Hwan Lee, Junghan Yoon, Dong Ryeol Ryu, Kyung Soon Hong, Byung Su Yoo

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Abstract

Background: Current hypertension treatment guidelines are focused on controlling mean blood pressure (BP). However, BP variability is a strong predictor of cardiovascular events, independent of mean BP. In addition, central BP may have a better predictive value for cardiovascular events, compared to brachial BP. A calcium channel blocker (CCB) or angiotensin converting enzyme inhibitor (ACEi) [or angiotensin II receptor blocker (ARB)] is recommended as the first-line drug for essential hypertension, although comparison studies of these anti-hypertensive drugs on BP variability and central BP are lacking. Therefore, the aim of this study is to assess systolic BP variability and central BP in essential hypertensive patients treated with a CCB or ARB. Methods and design: Eligible hypertensive patients will be randomized to either a CCB (amlodipine, 5 mg) or ARB (losartan, 50 mg) group. Medication will be titrated up according to the protocol, and patients will be followed up for 6 months. The primary efficacy endpoint will be the standard deviation of visit-to-visit systolic BP variability. The secondary efficacy endpoints will be central BP, central BP augmentation index, standard deviation of within-visit systolic BP variability, visit-to-visit systolic BP variability coefficient of variation, variability independent of the mean visit-to-visit systolic BP variability, 24-h ambulatory BP monitoring parameters (mean BP and daytime, nighttime, and daily systolic BP standard deviation), and at home systolic BP. Discussion: This prospective, open-label, multicenter, randomized study will compare the effects of a CCB (amlodipine) with ARB (losartan) on systolic BP variability and central BP. The results may guide the choice of anti-hypertensive drugs regarding these novel cardiovascular event predictive parameters. Trial registration number: Clinical Trials.gov: NCT01964079.

Original languageEnglish
Pages (from-to)1050-1056
Number of pages7
JournalExperimental and Clinical Cardiology
Volume20
Issue number7
Publication statusPublished - 2014 Jan 1

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Amlodipine
Losartan
Angiotensin Receptor Antagonists
Calcium Channel Blockers
Blood Pressure
Antihypertensive Agents

All Science Journal Classification (ASJC) codes

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{bffc5fc8c6e74af691ab4e62dc1883f7,
title = "Randomized comparison of systolic blood pressure variability (COMPASS-BPV) and central blood pressure in essential hypertensive patients treated with a calcium channel blocker (amlodipine) or angiotensin II receptor blocker (losartan)",
abstract = "Background: Current hypertension treatment guidelines are focused on controlling mean blood pressure (BP). However, BP variability is a strong predictor of cardiovascular events, independent of mean BP. In addition, central BP may have a better predictive value for cardiovascular events, compared to brachial BP. A calcium channel blocker (CCB) or angiotensin converting enzyme inhibitor (ACEi) [or angiotensin II receptor blocker (ARB)] is recommended as the first-line drug for essential hypertension, although comparison studies of these anti-hypertensive drugs on BP variability and central BP are lacking. Therefore, the aim of this study is to assess systolic BP variability and central BP in essential hypertensive patients treated with a CCB or ARB. Methods and design: Eligible hypertensive patients will be randomized to either a CCB (amlodipine, 5 mg) or ARB (losartan, 50 mg) group. Medication will be titrated up according to the protocol, and patients will be followed up for 6 months. The primary efficacy endpoint will be the standard deviation of visit-to-visit systolic BP variability. The secondary efficacy endpoints will be central BP, central BP augmentation index, standard deviation of within-visit systolic BP variability, visit-to-visit systolic BP variability coefficient of variation, variability independent of the mean visit-to-visit systolic BP variability, 24-h ambulatory BP monitoring parameters (mean BP and daytime, nighttime, and daily systolic BP standard deviation), and at home systolic BP. Discussion: This prospective, open-label, multicenter, randomized study will compare the effects of a CCB (amlodipine) with ARB (losartan) on systolic BP variability and central BP. The results may guide the choice of anti-hypertensive drugs regarding these novel cardiovascular event predictive parameters. Trial registration number: Clinical Trials.gov: NCT01964079.",
author = "Lee, {Jun Won} and Eunhee Choi and Lee, {Ji Hyun} and Youn, {Young Jin} and Ahn, {Sung Gyun} and Ahn, {Min Soo} and Kim, {Jang Young} and Lee, {Seung Hwan} and Junghan Yoon and Ryu, {Dong Ryeol} and Hong, {Kyung Soon} and Yoo, {Byung Su}",
year = "2014",
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language = "English",
volume = "20",
pages = "1050--1056",
journal = "Experimental and Clinical Cardiology",
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T1 - Randomized comparison of systolic blood pressure variability (COMPASS-BPV) and central blood pressure in essential hypertensive patients treated with a calcium channel blocker (amlodipine) or angiotensin II receptor blocker (losartan)

AU - Lee, Jun Won

AU - Choi, Eunhee

AU - Lee, Ji Hyun

AU - Youn, Young Jin

AU - Ahn, Sung Gyun

AU - Ahn, Min Soo

AU - Kim, Jang Young

AU - Lee, Seung Hwan

AU - Yoon, Junghan

AU - Ryu, Dong Ryeol

AU - Hong, Kyung Soon

AU - Yoo, Byung Su

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: Current hypertension treatment guidelines are focused on controlling mean blood pressure (BP). However, BP variability is a strong predictor of cardiovascular events, independent of mean BP. In addition, central BP may have a better predictive value for cardiovascular events, compared to brachial BP. A calcium channel blocker (CCB) or angiotensin converting enzyme inhibitor (ACEi) [or angiotensin II receptor blocker (ARB)] is recommended as the first-line drug for essential hypertension, although comparison studies of these anti-hypertensive drugs on BP variability and central BP are lacking. Therefore, the aim of this study is to assess systolic BP variability and central BP in essential hypertensive patients treated with a CCB or ARB. Methods and design: Eligible hypertensive patients will be randomized to either a CCB (amlodipine, 5 mg) or ARB (losartan, 50 mg) group. Medication will be titrated up according to the protocol, and patients will be followed up for 6 months. The primary efficacy endpoint will be the standard deviation of visit-to-visit systolic BP variability. The secondary efficacy endpoints will be central BP, central BP augmentation index, standard deviation of within-visit systolic BP variability, visit-to-visit systolic BP variability coefficient of variation, variability independent of the mean visit-to-visit systolic BP variability, 24-h ambulatory BP monitoring parameters (mean BP and daytime, nighttime, and daily systolic BP standard deviation), and at home systolic BP. Discussion: This prospective, open-label, multicenter, randomized study will compare the effects of a CCB (amlodipine) with ARB (losartan) on systolic BP variability and central BP. The results may guide the choice of anti-hypertensive drugs regarding these novel cardiovascular event predictive parameters. Trial registration number: Clinical Trials.gov: NCT01964079.

AB - Background: Current hypertension treatment guidelines are focused on controlling mean blood pressure (BP). However, BP variability is a strong predictor of cardiovascular events, independent of mean BP. In addition, central BP may have a better predictive value for cardiovascular events, compared to brachial BP. A calcium channel blocker (CCB) or angiotensin converting enzyme inhibitor (ACEi) [or angiotensin II receptor blocker (ARB)] is recommended as the first-line drug for essential hypertension, although comparison studies of these anti-hypertensive drugs on BP variability and central BP are lacking. Therefore, the aim of this study is to assess systolic BP variability and central BP in essential hypertensive patients treated with a CCB or ARB. Methods and design: Eligible hypertensive patients will be randomized to either a CCB (amlodipine, 5 mg) or ARB (losartan, 50 mg) group. Medication will be titrated up according to the protocol, and patients will be followed up for 6 months. The primary efficacy endpoint will be the standard deviation of visit-to-visit systolic BP variability. The secondary efficacy endpoints will be central BP, central BP augmentation index, standard deviation of within-visit systolic BP variability, visit-to-visit systolic BP variability coefficient of variation, variability independent of the mean visit-to-visit systolic BP variability, 24-h ambulatory BP monitoring parameters (mean BP and daytime, nighttime, and daily systolic BP standard deviation), and at home systolic BP. Discussion: This prospective, open-label, multicenter, randomized study will compare the effects of a CCB (amlodipine) with ARB (losartan) on systolic BP variability and central BP. The results may guide the choice of anti-hypertensive drugs regarding these novel cardiovascular event predictive parameters. Trial registration number: Clinical Trials.gov: NCT01964079.

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