The effects of missed doses of amlodipine and losartan on blood pressure in older hypertensive patients

Peter W. de Leeuw*, Robert Fagard, Abraham A. Kroon

*Corresponding author for this work

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This randomized, double-blind, parallel-group, multicenter study compared the efficacy of amlodipine and losartan in an older hypertensive population, focusing on therapeutic coverage in the case of missed doses. Following a 4-week, single-blind, placebo washout period, 211 patients were randomly assigned to receive either 5 mg of amlodipine once daily or 50 mg of losartan once daily. Doses were doubled after 6 weeks of treatment if the diastolic blood pressure exceeded 90 mm Hg. After the 12-week treatment period, patients received the placebo for 2 days (drug holiday) to simulate two missed doses of antihypertensive medication. Twenty-four-hour ambulatory blood pressure monitoring was conducted at the end of the placebo washout period (baseline), upon completion of the 12-week treatment period (steady state), and after the 2-day drug holiday. Amlodipine was more effective than losartan in reducing patients' 24-h ambulatory blood pressure at the steady-state sampling time. The increases in 24-h blood pressure during the drug holiday averaged 6 +/- 2/2 +/- 1 mm Hg (P

Original languageEnglish
Pages (from-to)568-572
Number of pages5
JournalHypertension Research
Issue number6
Publication statusPublished - Jun 2017


  • amlodipine
  • drug holiday
  • losartan
  • therapeutic coverage

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