Impact of amlodipine-based therapy on blood pressure time in target range in Chinese adults with primary hypertension: a retrospective study

Abstract

Background Recently, both international and Chinese guidelines have mentioned for the first time that blood pressure (BP) target range is more reasonable and workable than BP target in clinical practice, and time in target range (TTR) could become a potential evaluation indicator for long-term blood pressure management. Until now, there was no research on the long-term effects of antihypertensive treatment on systolic BP (SBP) TTR. The objective, therefore, is to observe the impact of long-acting calcium channel blockers (CCBs) on BP TTR in Chinese patients with hypertension (HTN).Methods A retrospective observational study was conducted using data from the China Cardiovascular Association Hypertension Centre, including 36,153 adult patients diagnosed with primary HTN and treated with amlodipine-based antihypertensive therapy between 1 January 2018 and 31 December 2022. The primary endpoint was the SBP TTR. Other endpoints included the annual trend of SBP TTR, factors influencing SBP TTR, etc.Results Results showed an overall SBP TTR was 80.42 ± 21.97%. The SBP TTR at 1, 2 and 3 years of follow-up was 79.49 ± 26.16%, 81.86 ± 25.10% and 82.79 ± 25.77%, respectively, showing a significant difference (p < 0.001). Seven factors were positively correlated with SBP TTR, while three factors were negatively correlated with SBP TTR including heart failure, high baseline SBP level, and high LDL-C level.Conclusion Long-term and continuous use of amlodipine-based antihypertensive therapy could improve SBP TTR. This finding may relate to the characteristic of amlodipine which is a long-acting drug due to pharmacokinetic properties.Trial registration Chinese Clinical Trial Registry Identifier: ChiCTR2400090150.

Keywords

• Amlodipine
• primary hypertension
• time in target range
• systolic blood pressure