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Efficacy of fixed-dose amlodipine and losartan combination compared with amlodipine monotherapy in stage 2 hypertension: a randomized, double blind, multicenter study
Soon-Yong Suh1  Young-Keun Ahn8  Jae-Joong Kim4  Hae-Young Lee5  Sang-Weon Park3  Woo-Shik Kim2  Jin-Ho Kang6  Nam-Ho Lee9  Kyu-Hyung Ryu7  Sung-Hae Kim7 
[1] Gachon University Gil Medical Center, Incheon, Korea;Cardiovascular Medicine Department, KyungHee University Medical Center, Seoul, Korea;Cardiology Department, Korea University Anam Hospital, Seoul, Korea;Department of Cardiology, Asan Medical Center, Seoul, Korea;Cardiology Department, Seoul National University Hospital, Seoul, Korea;Cardiology Department, Kangbuk Samsung Hospital, Seoul, Korea;Department of Cardiology, Konkuk University School of Medicine, Seoul, Korea;Cardiology Department, Chonnam National University Hospital, Gwangju, Korea;Cardiology Department, Hallym University Kangnam Sacred Heart Hospital, Gyeonggi, Korea
关键词: losartan;    amlodipine;    hypertension;   
Others  :  1167004
DOI  :  10.1186/1756-0500-4-461
 received in 2011-05-05, accepted in 2011-10-28,  发布年份 2011
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【 摘 要 】

Background

The objective of this trial was to compare the blood-pressure lowering efficacy of amlodipine/losartan combination with amlodipine monotherapy after 6 weeks of treatment in Korean patients with stage 2 hypertension.

Results

In this multi-center, double-blind, randomized study, adult patients (n = 148) with stage 2 hypertension were randomized to amlodipine 5 mg/losartan 50 mg or amlodipine 5 mg. After 2 weeks, patients with systolic blood pressure (SBP) > 140 mmHg were titrated to amlodipine 10 mg/losartan 50 mg or amlodipine 10 mg. After 4 weeks of titration, hydrochlorothiazide 12.5 mg could be optionally added to both groups. The change from baseline in SBP was assessed after 6 weeks. The responder rate (defined as achieving SBP < 140 mmHg or DBP < 90 mmHg) was also assessed at 2, 6 and 8 weeks as secondary endpoints. Safety and tolerability were assessed through adverse event monitoring and laboratory testing. Baseline demographics and clinical characteristics were generally similar between treatment groups. Least-square mean reduction in SBP at 6 weeks (primary endpoint) was significantly greater in the combination group (36.5 mmHg vs. 31.6 mmHg; p = 0.0117). The responder rate in SBP (secondary endpoints) was significantly higher in the combination group at 2 weeks (52.1% vs. 33.3%; p = 0.0213) but not at 6 weeks (p = 0.0550) or 8 weeks (p = 0.0592). There was no significant difference between groups in the incidence of adverse events.

Conclusion

These results demonstrate that combination amlodipine/losartan therapy provides an effective and generally well-tolerated first line therapy for reducing blood pressure in stage 2 hypertensive patients.

Trial Registration

ClinicalTrials.gov: NCT01127217

【 授权许可】

   
2011 Ryu et al; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Ezzati M, Lopez AD, Rodgers A, Vander HS, Murray CJ: Selected major risk factors and global and regional burden of disease. Lancet 2002, 360:1347-1360.
  • [2]Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J: Global burden of hypertension: analysis of worldwide data. Lancet 2005, 365:217-223.
  • [3]Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, et al.: The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003, 289:2560-2572.
  • [4]Okonofua EC, Simpson KN, Jesri A, Rehman SU, Durkalski VL, Egan BM: Therapeutic inertia is an impediment to achieving the Healthy People 2010 blood pressure control goals. Hypertension 2006, 47:345-351.
  • [5]Selby JV, Lee J, Swain BE, Tavel HM, Ho PM, Margolis KL, O'Connor PJ, Fine L, Schmittdiel JA, Magid DJ: Trends in time to confirmation and recognition of new-onset hypertension, 2002-2006. Hypertension 2010, 56:605-611.
  • [6]Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, et al.: 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension. J Hypertens 2007, 25:1751-1762.
  • [7]Osswald H, Muhlbauer B: The pharmacological basis for the combination of calcium channel antagonists and angiotensin converting enzyme inhibitors in the treatment of hypertension. J Hypertens Suppl 1995, 13:S21-S28.
  • [8]Brenner BM, Cooper ME, de Zeeuw D, Keane WF, Mitch WE, Parving HH, Remuzzi G, Snapinn SM, Zhang Z, Shahinfar S: Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001, 345:861-869.
  • [9]Lindholm LH, Ibsen H, Dahlof B, Devereux RB, Beevers G, de Faire U, Fyhrquist F, Julius S, Kjeldsen SE, Kristiansson K, et al.: Cardiovascular morbidity and mortality in patients with diabetes in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002, 359:1004-1010.
  • [10]Chiang CE, Wang TD, Li YH, Lin TH, Chien KL, Yeh HI, Shyu KG, Tsai WC, Chao TH, Hwang JJ, et al.: 2010 guidelines of the Taiwan Society of Cardiology for the management of hypertension. J Formos Med Assoc 2010, 109:740-773.
  • [11]Chung JW, Lee HY, Kim CH, Seung IW, Shin YW, Jeong MH, Cho MC, Oh BH: Losartan/Hydrochlorothiazide fixed combination versus amlodipine monotherapy in korean patients with mild to moderate hypertension. Korean Circ J 2009, 39:151-156.
  • [12]Dahlof B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, de Faire U, Fyhrquist F, Ibsen H, Kristiansson K, Lederballe-Pedersen O, et al.: Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet 2002, 359:995-1003.
  • [13]Gokhale N, Shahani S, Pawar D: Efficacy and safety of losartan-amplodipine combination--an Indian postmarketing surveillance experience. J Indian Med Assoc 2002, 100:207-208.
  • [14]Kohlmann O Jr, Oigman W, Mion D Jr, Rocha JC, Gomes MA, Salgado N, Feitosa GS, Dallaverde E, Ribeiro AB: The "LOTHAR" study: evaluation of efficacy and tolerability of the fixed combination of amlodipine and losartan in the treatment of essential hypertension. Arq Bras Cardiol 2006, 86:39-51.
  • [15]Hilleman DE, Reyes AP, Wurdeman RL, Faulkner M: Efficacy and safety of a therapeutic interchange from high-dose calcium channel blockers to a fixed-dose combination of amlodipine/benazepril in patients with moderate-to-severe hypertension. J Hum Hypertens 2001, 15:559-565.
  • [16]Neutel JM, Smith DH, Weber MA, Schofield L, Purkayastha D, Gatlin M: Efficacy of combination therapy for systolic blood pressure in patients with severe systolic hypertension: the Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) study. J Clin Hypertens (Greenwich) 2005, 7:641-646.
  • [17]Elliott WJ, Montoro R, Smith D, Leibowitz M, Hwang C, Gradman AH, Schleman M, Klibaner M: Comparison of two strategies for intensifying antihypertensive treatment: low-dose combination (enalapril + felodipine ER) versus increased dose of monotherapy (enalapril). LEVEL (Lexxel vs Enalapril) Study Group. Am J Hypertens 1999, 12:691-696.
  • [18]Jamerson K, Weber MA, Bakris GL, Dahlof B, Pitt B, Shi V, Hester A, Gupte J, Gatlin M, Velazquez EJ: Benazepril plus amlodipine or hydrochlorothiazide for hypertension in high-risk patients. N Engl J Med 2008, 359:2417-2428.
  • [19]Flack JM, Calhoun DA, Satlin L, Barbier M, Hilkert R, Brunel P: Efficacy and safety of initial combination therapy with amlodipine/valsartan compared with amlodipine monotherapy in black patients with stage 2 hypertension: the EX-STAND study. J Hum Hypertens 2009, 23:479-489.
  • [20]Sharma A, Bagchi A, Kinagi SB, Sharma YK, Baliga VP, Bollmall C: Results of a comparative, phase III, 12-week, multicenter, prospective, randomized, double-blind assessment of the efficacy and tolerability of a fixed-dose combination of telmisartan and amlodipine versus amlodipine monotherapy in Indian adults with stage II hypertension. Clin Ther 2007, 29:2667-2676.
  • [21]Chrysant SG, Melino M, Karki S, Lee J, Heyrman R: The combination of olmesartan medoxomil and amlodipine besylate in controlling high blood pressure: COACH, a randomized, double-blind, placebo-controlled, 8-week factorial efficacy and safety study. Clin Ther 2008, 30:587-604.
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