White 1999a.
Methods | randomized, double blind , double‐dummy, crossover design. 3‐week single blind, placebo run‐in period, 8‐week double‐blind crossover treatment period (each 4 weeks) sample size calculation: yes carryover effects: not reported no washout period between treatment arms | |
Participants | Country: the United States Number randomised: 85,75 completed Mean age: 57.8±9.1(SD) years gender: 43 men, 32 women, . Ethnicity: 46 White, 26 Black, 2 Hispanic, 1 Asian. Inclusion criteria: age≥21 years, seated office DBP≥90 mm Hg and ≥109 mm Hg exclusion criteria: secondary hypertension, SBP>200 mm Hg or DBP≥110 mm Hg, bradycardia , tachycardia , stroke or myocardial infarction in the previous 6 months, congestive heart failure, clinically significant hepatic or renal disease, uncontrolled diabetes mellitus, life‐style factors such as night‐shift work or regular naps during the daytime, or history of allergy or intolerance to study medications. | |
Interventions | 20 mg nisoldipine ER in the morning , and matching placebo in the evening, N=85 20 mg nisoldipine ER in the evening, and matching placebo in the morning: N=85 | |
Outcomes |
Mortality: not reported Morbidity: not reported Blood Pressure data: 24h BP change by 24h ABPM (table 3 on page 809) Adverse Events: not reported |
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Notes | ||
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | randomization schedule |
Allocation concealment (selection bias) | Unclear risk | not reported |
Blinding (performance bias and detection bias) All outcomes | Low risk | double‐dummy, matching placebo |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Data in all patients were reported. eight patient withdrawn for adverse events, two patients were lost to follow‐up. |
Selective reporting (reporting bias) | Low risk | All outcomes were reported. |
Other bias | Unclear risk | carryover effects were not reported. |
BP: blood pressure
SBP: Systolic blood pressure
DBP: diastolic blood pressure
MI: Myocardial infarction
GITS: gastrointestinal therapeutic system
HR: heart rate
ABPM: ambulatory blood pressure monitoring
JNC: Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
ER: extended‐release
SD: standard deviation
SE: standard error
h: hour
BMI: body mass index
WHO: World Health Organization
COER: controlled onset extended release
GRD: graded‐release diltiazem HCl extended‐release
PROBE: prospective, randomized, open‐label, blinded end point
MAPEC: Ambulatory Blood Pressure Monitoring in the Prediction of Cardiovascular Events and Effects of Chronotherapy