title: Combination delapril/manidipine as antihypertensive therapy in high-risk patients.
abstract: The majority of patients with hypertension, and in particular high-risk patients or those with diabetes mellitus or renal dysfunction, are likely to require combination therapy with at least two antihypertensive agents (from different classes) to achieve their blood pressure (BP) target. The delapril/manidipine fixed-dose combination consists of two antihypertensive agents with different, yet complementary, mechanisms of action. Delapril/manidipine has demonstrated short- and long-term antihypertensive efficacy in a number of clinical studies in patients with hypertension with an inadequate response to monotherapy. Comparative studies have demonstrated that delapril/manidipine is as effective as enalapril/hydrochlorothiazide (HCTZ) in patients with hypertension with an inadequate response to monotherapy, and as effective as irbesartan/HCTZ, losartan/HCTZ, olmesartan medoxomil/HCTZ, ramipril/HCTZ and valsartan/HCTZ in reducing BP in patients with hypertension and diabetes, or in obese patients with hypertension. Therapy with delapril/manidipine also appears to exert beneficial effects that extend beyond a reduction in BP, including nephroprotective activity and an improvement in fibrinolytic balance, supporting its value as a treatment option in these patient populations at high or very high cardiovascular risk because of the presence of organ damage, diabetes or renal disease.
authors.affiliation: Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy. r.fogari@smatteo.pv.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Fogari
authors.forename: Amedeo
authors.initials: A
authors.lastname: Mugellini
authors.forename: Maria
authors.initials: M
authors.lastname: Circelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cremonesi
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D002986:Clinical Trials as Topic; D048909:Diabetes Complications / Q000188:drug therapy*; D004095:Dihydropyridines / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D004656:Enalapril / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000627:therapeutic use; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage / Q000627:therapeutic use; D007189:Indans / Q000008:administration & dosage / Q000627:therapeutic use*; D000077405:Irbesartan; D019808:Losartan / Q000008:administration & dosage / Q000627:therapeutic use; D009578:Nitrobenzenes; D009765:Obesity / Q000150:complications / Q000188:drug therapy*; D000068557:Olmesartan Medoxomil; D010879:Piperazines; D017257:Ramipril / Q000008:administration & dosage / Q000627:therapeutic use; D013777:Tetrazoles / Q000008:administration & dosage / Q000627:therapeutic use; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D004095:Dihydropyridines; D004338:Drug Combinations; D007093:Imidazoles; D007189:Indans; D009578:Nitrobenzenes; D010879:Piperazines; D013777:Tetrazoles; D006852:Hydrochlorothiazide; D004656:Enalapril; D000068557:Olmesartan Medoxomil; C054218:manidipine; D000068756:Valsartan; D014633:Valine; D000077405:Irbesartan; D019808:Losartan; D017257:Ramipril; C047759:delapril