Objective: to assess the efficacy and safety of the clonidine transdermal therapeutic system (CTTS) vs enalapril (E) in elderly patients with isolated systolic hypertension (ISH) from their clinical (C) and 24-hour ambulatory (A) blood pressure (BP) values. Methods: this was an Italian, multicenter, open label, randomized study. After 2-week wash-out period, 90 elderly patients (mean age±SD: 69±6 years) with ISH (systolic blood pressure, SBP 175±12 mmHg; diastolic blood pressure, DBP 86±6 mmHg) were randomized to 2 weeks of treatment with CTTS1 once a week (0.1 mg/day) or E 10 mg once a day. In non-responders (SBP >150 mmHg during treatment or a <20 mmHg reduction from baseline), the dose of CTTS and E was doubled after two further weeks, and a combination of CTTS 1-2 and E 10-20 mg was started if the patients were still non-responders after the next 2 weeks. The treatment was then continued unchanged for 3 months. At the end of the wash-out and the treatment periods, BP was measured with a semiautomatic device in the doctor's office (CBP) and over 24 hours by ambulatory blood pressure monitoring (ABPM). Results: clinical SBP was similarly reduced (32±17, 34±15 and 31±17 mmHg) for CTTS (n=38), E (n=41), and CTTS+E (n=11) respectively. The reduction in 24-hour SBP was similar between CTTS (16±9 mmHg; n=31) and E (19±15 mmHg; n=37), while it was slightly, although not statistically significant, greater for CTTS +E (23±9 mmHg; n=10). Similar results were observed for the daytime and nighttime sub-periods and for each hour of the recording. The two single treatments and their combination did not significantly affect C DBP, A DBP and heart rate. The CTTS was well tolerated and skin reactions were the only adverse events seldom observed (five patients). Conclusions: CTTS is an effective antihypertensive drug in elderly patients with ISH. It reduces SBP over the 24 hours and does not affect DBP and HR.

Efficacy of the clonidine transdermal therapeutic system (CTTS) compared to enalapril in an elderly population with isolated systolic hypertension

PORTALUPPI, Francesco;
1998

Abstract

Objective: to assess the efficacy and safety of the clonidine transdermal therapeutic system (CTTS) vs enalapril (E) in elderly patients with isolated systolic hypertension (ISH) from their clinical (C) and 24-hour ambulatory (A) blood pressure (BP) values. Methods: this was an Italian, multicenter, open label, randomized study. After 2-week wash-out period, 90 elderly patients (mean age±SD: 69±6 years) with ISH (systolic blood pressure, SBP 175±12 mmHg; diastolic blood pressure, DBP 86±6 mmHg) were randomized to 2 weeks of treatment with CTTS1 once a week (0.1 mg/day) or E 10 mg once a day. In non-responders (SBP >150 mmHg during treatment or a <20 mmHg reduction from baseline), the dose of CTTS and E was doubled after two further weeks, and a combination of CTTS 1-2 and E 10-20 mg was started if the patients were still non-responders after the next 2 weeks. The treatment was then continued unchanged for 3 months. At the end of the wash-out and the treatment periods, BP was measured with a semiautomatic device in the doctor's office (CBP) and over 24 hours by ambulatory blood pressure monitoring (ABPM). Results: clinical SBP was similarly reduced (32±17, 34±15 and 31±17 mmHg) for CTTS (n=38), E (n=41), and CTTS+E (n=11) respectively. The reduction in 24-hour SBP was similar between CTTS (16±9 mmHg; n=31) and E (19±15 mmHg; n=37), while it was slightly, although not statistically significant, greater for CTTS +E (23±9 mmHg; n=10). Similar results were observed for the daytime and nighttime sub-periods and for each hour of the recording. The two single treatments and their combination did not significantly affect C DBP, A DBP and heart rate. The CTTS was well tolerated and skin reactions were the only adverse events seldom observed (five patients). Conclusions: CTTS is an effective antihypertensive drug in elderly patients with ISH. It reduces SBP over the 24 hours and does not affect DBP and HR.
1998
Portaluppi, Francesco; S., Omboni; M., Campanini; C., Macchiarulo; E., Ambrosioni; A., Salvetti; G., Mancia
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11392/1679284
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