From the Guidelines
The target blood pressure for a patient on Amlodipine with hypertension is less than 130/80 mm Hg.
Target Blood Pressure
- The American Heart Association recommends a target blood pressure of less than 130/80 mm Hg for patients with hypertension 1.
- The European Society of Cardiology also recommends a similar target blood pressure for patients with heart failure and hypertension 1.
- The American College of Cardiology and American Heart Association guideline for the prevention, detection, evaluation, and management of high blood pressure in adults also recommends a target blood pressure of less than 130/80 mm Hg 1.
Administration of Hydralazine
- Hydralazine is recommended when hypertension persists despite treatment with a combination of as many as possible of an ACE inhibitor (or ARB), beta-blocker, MRA, and diuretic 1.
- The initial dose of Hydralazine is 10 mg via slow IV infusion (maximum initial dose 20 mg), and it can be repeated every 4-6 hours as needed 1.
- Hydralazine is not a desirable first-line agent for acute treatment in most patients due to its unpredictability of response and prolonged duration of action 1.
Key Points
- Amlodipine is recommended when hypertension persists despite treatment with a combination of as many as possible of an ACE inhibitor (or ARB), beta-blocker, MRA, and diuretic 1.
- The treatment of hypertension in patients with heart failure should include behavioral modification, such as sodium restriction, and a closely monitored exercise program 1.
- The selection of an antihypertensive agent should be based on the drug's pharmacology, pathophysiological factors underlying the patient's hypertension, degree of progression of target organ damage, the desirable rate of BP decline, and the presence of comorbidities 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Target Blood Pressure for Patients on Amlodipine
- The target blood pressure for patients with hypertension, including those on Amlodipine, is generally considered to be less than 130/80 mmHg, especially for those with diabetes or chronic kidney disease 2, 3.
- For patients without diabetes or chronic kidney disease, the target blood pressure is often considered to be less than 140/90 mmHg 3.
Administration of Hydralazine
- Hydralazine, particularly IV hydralazine, has been shown to be effective in lowering blood pressure in patients with severe hypertension, with a significant drop in blood pressure compared to no treatment 4.
- The decision to administer Hydralazine should be based on the patient's individual needs and medical history, and should be made in consultation with a healthcare professional.
- There is no specific guidance on when to administer Hydralazine in relation to Amlodipine, but it is likely that Hydralazine would be considered for patients who are not responding to Amlodipine or other antihypertensive medications, or who require more rapid blood pressure control 4.
Efficacy of Amlodipine
- Amlodipine has been shown to be effective in reducing blood pressure in patients with hypertension, including those with diabetes or chronic kidney disease 5, 2, 6.
- Amlodipine has a long half-life and duration of action, allowing it to sustain its anti-hypertensive effect for more than 24 hours following a single dose 5.
- Amlodipine is generally well-tolerated, but can cause side effects such as edema, palpitations, dizziness, and flushing, particularly at higher doses 5.