Effect 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

Paul Muntner, Emily B. Levitan, Amy I. Lynch, Lara M. Simpson, Jeffrey Whittle, Barry R. Davis, John B. Kostis, Paul K. Whelton, Suzanne Oparil

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)323-330
Number of pages8
JournalJournal of Clinical Hypertension
Volume16
Issue number5
DOIs
StatePublished - May 2014

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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