RESPONSES TO ALISKIREN/HCTZ VERSUS AMLODIPINE ON PERIPHERAL AND CENTRAL BLOOD
PRESSURE IN AFRICAN AMERICAN PATIENTS WITH STAGE 2 HYPERTENSION
ACC Poster Contributions
Georgia World Congress Center, Hall B5
Tuesday, March 16, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Central Blood Pressure Drugs and Genes
Abstract Category: Hypertension
Presentation Number: 1240-103
Authors: Keith Ferdinand, James Pool, Richard Weitzman, Das Purkayastha, Raymond Townsend, Emory University, Decatur, GA
Background: In African American (AA) men, central BP may better reflect the levels of vascular burden than peripheral (brachial) BP. There is
a paucity of data on the efficacy of antihypertensive agents on central pressure in AA. This 8-week prospective, multicenter, randomized, doubleblind
study of AA patients with stage 2 (MSSBP ≥ 160 mmHg and < 200 mmHg) hypertension evaluated the brachial and central BP responses of
treatment with the single pill combination aliskiren/HCTZ (A/H) compared with amlodipine (AML).
Methods: Following a 1-4 week washout eligible patients ≥18 years (mean age= 52.6), received either A/H150/12.5 mg (n=166) or AML 5 mg
(n=166) for 1 week; force titrated to A/H 300/25 or AML 10 mg for 7 weeks. Primary efficacy was change from baseline in MSSBP at Week 8. A
substudy (n=52) evaluated treatment differences in central BP.
Results: At week 8, both treatments provided significant reductions in MSSBP from baseline [-28.6 ±17.95, -28.2 ± 13.17 mm Hg] in the A/H
and AML arms, with no significant differences between treatments. However, A/H significantly reduced (p <0.05) central SBP and increased pulse
pressure amplification ratio (brachial/central) vs AML (Table). Both treatments were well tolerated.
Conclusion: Despite similar reductions in peripheral SBP with the 2 treatments, reductions in central systolic pressure was significantly in favor of
A/H. Our findings suggest an important new treatment option since central pressure is considered an important risk factor in AA patients.