title: Combination of antihypertensive therapy in the elderly, multicenter investigation (CAMUI) trial: results after 1 year.
abstract: OBJECTIVE
  Combination therapy with angiotensin receptor blockers (ARBs) and calcium channel blockers or diuretics is common for hypertensive patients. This study aimed to determine which combination is better for elderly hypertensive patients.
  
  
  METHODS
  In this prospective, randomized, open-label trial, hypertensive outpatients aged at least 65 years who had not achieved their target blood pressure (BP) with standard ARB dosages were randomly assigned to receive either a fixed-dose combination of losartan (50 mg) and hydrochlorothiazide (12.5 mg) (ARB+D; n = 72) or a combination of amlodipine (5 mg) and the typical dosage of ARBs (ARB+C; n = 68) to evaluate the change in the BP, laboratory values and cognitive function.
  
  
  RESULTS
  At 3 months, the SBP/DBP was found to have significantly decreased from 156/83 ± 15/11 mmHg to 139/76 ± 14/10 mmHg in the ARB+D group and 155/83 ± 11/10 mmHg to 132/72 ± 14/10 mmHg in the ARB+C group. The BP reduction efficacy was greater in the ARB+C group than in the ARB+D group. At 6 months, the SBP/DBP reached the same level in both groups. At 12 months, the urine albumin/creatinine ratio was significantly decreased from the geometric mean of 17.1 to 9.6 mg/g in the ARB+D group, whereas it was increased from 19.8 to 23.7 mg/g in the ARB+C group. Conversely, the estimated glomerular filtration rate tended to show a decrease in the ARB+D group. There was no significant difference in mini-mental state examination after 1 year.
  
  
  CONCLUSIONS
  ARB+amlodipine (5 mg) yielded a greater BP reduction, whereas ARB+HCTZ (12.5 mg) resulted in a greater reduction in the albuminuria, suggesting that each combination therapy is advantageous in a different manner for elderly hypertensive patients.
authors.affiliation: Department of Cardiology, Asahikawa Medical University, Hokkaido 078–8510, Japan. nsato@asahikawamed.ac.jp
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sato
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Saijo
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sasagawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Morimoto
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Sano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Koyama
authors.forename: Naofumi
authors.initials: N
authors.lastname: Takehara
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Morita
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Sumitomo
authors.forename: Junichi
authors.initials: J
authors.lastname: Maruyama
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kikuchi
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Hasebe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017311:Amlodipine / Q000494:pharmacology / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects; D004232:Diuretics / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000494:pharmacology / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy*; D019808:Losartan / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male
chemical_list: D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D006852:Hydrochlorothiazide; D017311:Amlodipine; D019808:Losartan