title: Additive antihypertensive and antihypertrophic effects of long-acting Ca blockers in uncontrolled hypertensive patients with angiotensin-receptor blocker based treatment.
abstract: The aim of the present study was to examine the antihypertensive and antihypertrophic effects of combined treatment with a long-acting calcium antagonist on top of an angiotensin II receptor blocker (ARB) in uncontrolled hypertensive patients. Patients with essential hypertension and a blood pressure > 140/90 mmHg on ARB monotherapy (losartan 50 mg/day or candesartan 8 mg/day) were randomly assigned to a nifedipine controlled release (CR) group (n = 15) or amlodipine group (n = 11). A significant additional antihypertensive effect was noted from 1 month with nifedipine and 2 months with amlodipine. The average daily dose was 25 mg for nifedipine and 5 mg for amlodipine. The cardiothoracic ratio was significantly reduced in both groups after 3 months. Left ventricular wall thickness and left ventricular mass index also decreased. Metabolic parameters, hepatic function, and renal function did not change significantly. Additional treatment with a long-acting calcium antagonist achieved further blood pressure reduction as well as an antihypertrophic effect in the uncontrolled patients with prior ARB monotherapy.
authors.affiliation: Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Sunao
authors.initials: S
authors.lastname: Kodama
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Inoue
authors.forename: Kei
authors.initials: K
authors.lastname: Miyoshi
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Sumi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Okamura
authors.forename: Hideaki
authors.initials: H
authors.lastname: Tojyo
authors.forename: Chie
authors.initials: C
authors.lastname: Ando
authors.forename: Hideya
authors.initials: H
authors.lastname: Niimura
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tsuchiya
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Mihara
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamanouchi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Urata
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000008:administration & dosage*; D001562:Benzimidazoles / Q000008:administration & dosage*; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage*; D013777:Tetrazoles / Q000008:administration & dosage*
chemical_list: D001562:Benzimidazoles; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D013777:Tetrazoles; D017311:Amlodipine; D009543:Nifedipine; D019808:Losartan; C081643:candesartan