title: Beneficial effect of combination therapy with antihypertensive drugs in patients with hypertension.
abstract: BACKGROUND
  Cardiac hypertrophy and failure are major complications of hypertension.
  
  
  OBJECTIVE
  The beneficial effect of treatment with antihypertensive drugs on serum levels of brain natriuretic peptide (BNP) was examined in patients with essential hypertension.
  
  
  METHODS
  Antihypertensive drugs were administered to 88 hypertensive patients (44 diabetic and 44 nondiabetic) whose systolic blood pressure was greater than 140 mmHg and/or diastolic blood pressure was greater than 90 mmHg. Other antihypertensive drugs were added every two months until the blood pressure fell below 130/85 mmHg. Candesartan, benidipine, bisoprolol or celiprolol, and bunazosin were administered in this order.
  
  
  RESULTS
  The mean systolic blood pressure was reduced from 163.7+/-11.6 mmHg to 121.8+/-7.5 mmHg after 12 months in patients with diabetes and from 167.6+/-12.3 mmHg to 122.8+/-7.5 mmHg in patients without diabetes. The mean diastolic blood pressure was also significantly reduced in patients with and without diabetes. Serum BNP levels were reduced from 52.2+/-38.8 pg/mL to 38.8+/-30.9 pg/mL in patients with diabetes and from 47.1+/-34.2 pg/mL to 35.8+/-22.5 pg/mL in patients without diabetes. In patients older than 70 years of age, serum BNP levels were reduced from 56.3+/-39.3 pg/mL to 40.2+/-23.0 pg/mL in those with diabetes and from 54.6+/-32.9 pg/mL to 38.0+/-16.0 pg/mL in those without diabetes.
  
  
  CONCLUSIONS
  These results indicate that combination therapy with antihypertensive drugs is usually necessary to reduce blood pressure to below 130/85 mmHg and to improve serum BNP levels.
authors.affiliation: Department of Internal Medicine, Aoto Hospital, Jikei University School of Medicine.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Shikata
authors.forename: Tetsuaki
authors.initials: T
authors.lastname: Sekikawa
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kimura
authors.forename: Akira
authors.initials: A
authors.lastname: Kojima
authors.forename: Shingo
authors.initials: S
authors.lastname: Seki
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Oka
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishiyama
authors.forename: Nobuakira
authors.initials: N
authors.lastname: Takeda