Amlodipine/benazepril combination therapy for hypertensive patients nonresponsive to benazepril monotherapy

被引:25
作者
Chrysant, SG
Bakris, GL
机构
[1] Oklahoma Cardiovasc & Hypertens Ctr, Oklahoma City, OK 73132 USA
[2] Univ Oklahoma, Sch Med, Oklahoma City, OK USA
[3] Rush Hypertens Clin Res Ctr, Dept Prevent Med & Internal Med, Chicago, IL USA
关键词
amlodipine; benazepril; hypertension;
D O I
10.1016/j.amjhyper.2004.03.679
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Background: Most patients with hypertension require two or more antihypertensive medications to achieve blood pressure (BP) goals. This double-blind study compared the efficacy and safety of high-dose combinations of amlodipine besylate (5 mg and 10 mg) and benazepril hydrochloride (40 mg) to benazepril hydrochloride (40 mg) alone in hypertensive patients not adequately controlled with benazepril hydrochloride (40 mg) monotherapy. Methods: After a 2-week washout period and a 4-week lead-in period with benazepril 40 mg daily, patients with a mean sitting diastolic BP greater than or equal to95 mm Hg (i.e., nonresponders to benazepril 40 mg) were randomly assigned to active treatment with either a combination of amlodipine 5 mg and benazepril 40 mg for 4 weeks followed by a forced titration to amlodipine 10 mg and benazepril 40 mg for an additional 4 weeks, or to benazepril 40 mg alone for 8 weeks. Results: The mean reduction in sitting BP from baseline (on benazepril) to endpoint (after 8 weeks of treatment) was 17/14 mm Hg with amlodipine/benazepril and 5/7 mm Hg with benazepril (P < .0001). The percentage of patients who met the diastolic BP response criteria (<90 mm Hg at endpoint or :10 nun Hg decrease from baseline) was 80% in the amlodipine/benazepril group and 45% in the benazepril group (P < .0001). The incidence-of adverse events was infrequent and comparable for both treatment groups. Conclusion: High-dose amlodipine/benazepril combination therapy (5 mg/40 mg and 10 mg/40 mg) is an effective, safe, and well-tolerated treatment option for hypertensive patients who do not respond adequately to benazepril alone. (C) 2004 American Journal of Hypertension, Ltd.
引用
收藏
页码:590 / 596
页数:7
相关论文
共 32 条
[1]   Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study [J].
Adler, AI ;
Stratton, IM ;
Neil, HAW ;
Yudkin, JS ;
Matthews, DR ;
Cull, CA ;
Wright, AD ;
Turner, RC ;
Holman, RR .
BMJ-BRITISH MEDICAL JOURNAL, 2000, 321 (7258) :412-419
[2]  
[Anonymous], 1992, NEW ENGL J MED, V327, P685, DOI [DOI 10.1056/NEJM199209033271003, 10.1056/NEJM199209033271003.Erratumin]
[3]  
AYLA C, 2002, MMWR-MORBID MORTAL W, V51, P456
[4]  
Bakris George L, 2003, J Clin Hypertens (Greenwich), V5, P202, DOI 10.1111/j.1524-6175.2002.2041.x
[5]   Preserving renal function in adults with hypertension and diabetes: A consensus approach [J].
Bakris, GL ;
Williams, M ;
Dworkin, L ;
Elliott, WJ ;
Epstein, M ;
Toto, R ;
Tuttle, K ;
Douglas, J ;
Hsueh, W ;
Sowers, J .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2000, 36 (03) :646-661
[6]   Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [J].
Chobanian, AV ;
Bakris, GL ;
Black, HR ;
Cushman, WC ;
Green, LA ;
Izzo, JL ;
Jones, DW ;
Materson, BJ ;
Oparil, S ;
Wright, JT ;
Roccella, EJ .
HYPERTENSION, 2003, 42 (06) :1206-1252
[7]   Vascular remodeling: The role of angiotensin-converting enzyme inhibitors [J].
Chrysant, SG .
AMERICAN HEART JOURNAL, 1998, 135 (02) :S21-S30
[8]   Fixed low-dose drug combination for the treatment of hypertension [J].
Chrysant, SG .
ARCHIVES OF FAMILY MEDICINE, 1998, 7 (04) :370-376
[9]  
Dzau VJ, 2001, AM J CARDIOL, V88, p1L
[10]   Newer approaches to antihypertensive therapy - Use of fixed-dose combination therapy [J].
Epstein, M ;
Bakris, G .
ARCHIVES OF INTERNAL MEDICINE, 1996, 156 (17) :1969-1978