Additive antihypertensive and antihypertrophic effects of long-acting Ca blockers in uncontrolled hypertensive patients with angiotensin-receptor blocker based treatment.
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.
Kodama
Sunao
S
Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Inoue
Yukiko
Y
Miyoshi
Kei
K
Sumi
Shunichiro
S
Okamura
Keisuke
K
Tojyo
Hideaki
H
Ando
Chie
C
Niimura
Hideya
H
Tsuchiya
Yoshihiro
Y
Mihara
Hiroyuki
H
Yamanouchi
Yoshio
Y
Urata
Hidenori
H
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*
D001562:Benzimidazoles; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D013777:Tetrazoles; D017311:Amlodipine; D009543:Nifedipine; D019808:Losartan; C081643:candesartan