| Additional antihypertensive effect of drugs in hypertensive subjects uncontrolled on diltiazem monotherapy: a randomized controlled trial using office and home blood pressure monitoring. | |
| | |
MedLine Citation:
|
PMID: 17060064 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The purpose of this study was to compare several diltiazem-based antihypertensive drug combinations and assess the usefulness of home blood pressure monitoring in the evaluation of the efficacy of combination pharmacotherapy. Sixteen general practitioners recruited hypertensive subjects uncontrolled on diltiazem monotherapy, who were randomized to receive eight weeks of add-on therapy with a diuretic (chlorthalidone), a dihydropyridine calcium antagonist (felodipine), an ACE inhibitor (lisinopril), or an angiotensin blocker (valsartan). Sitting office and home blood pressure was measured using electronic devices A&D 767. A total of 211 patients were randomized, and 185 completed the study. Of 52 subjects randomized to felodipine, 15 were withdrawn due to ankle edema. The additional antihypertensive effect of the second drug was smaller in 18 subjects with a white coat effect (p < 0.01). All combinations produced a significant decline in office (21.2 +/- 14.8 / 7.7 +/- 9.7 mmHg) and home (17.1 +/- 11.9 / 6.0 +/- 7.0) blood pressure (systolic / diastolic, p < 0.001). There were no differences in the efficacy of the four combinations assessed using office or home blood pressure monitoring. These data suggest that diuretics, dihydropyridines, ACE inhibitors, and angiotensin receptor blockers provide significant additional antihypertensive effects in hypertensive patients uncontrolled on diltiazem monotherapy. The diltiazem-dihydropyridine combination is often intolerable because of ankle edema. Home blood pressure monitoring is useful in the assessment of the efficacy of combination pharmacotherapy and also allows for the detection of subjects who do not require treatment intensification. |
| | |
Authors:
|
Antonis K Karotsis; Athanasios Symeonidis; Stylianos E Mastorantonakis; George S Stergiou; |
Related Documents
:
|
10212374 - Target-organ damage and cardiovascular risk profile in resistant hypertension. influenc... 17351384 - Low-dose spironolactone in the management of resistant hypertension: a surveillance study. 11986884 - Hypertension in brazil. 20863494 - The effect of walking intervention on blood pressure control: a systematic review. 7214394 - Influence of static and oscillatory pressure/strain on 131i-albumin uptake by the wall ... 11950484 - The optimal dosage of ketanserin for patients with severe hypertension in pregnancy. |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
|
Title: Clinical and experimental hypertension (New York, N.Y. : 1993) Volume: 28 ISSN: 1064-1963 ISO Abbreviation: Clin. Exp. Hypertens. Publication Date: 2006 Oct |
Date Detail:
|
Created Date: 2006-10-24 Completed Date: 2006-11-14 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9305929 Medline TA: Clin Exp Hypertens Country: United States |
Other Details:
|
Languages: eng Pagination: 655-62 Citation Subset: IM |
Affiliation:
|
Hypertension Center, Third University Department of Medicine, Sotiria Hospital, Athens, Greece. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Angiotensin II Type 1 Receptor Blockers / pharmacology, therapeutic use Angiotensin-Converting Enzyme Inhibitors / pharmacology, therapeutic use Antihypertensive Agents / pharmacology, therapeutic use* Blood Pressure / drug effects, physiology Blood Pressure Monitoring, Ambulatory* Calcium Channel Blockers / pharmacology, therapeutic use Chlorthalidone / pharmacology, therapeutic use Diltiazem / pharmacology, therapeutic use* Drug Therapy, Combination Felodipine / pharmacology, therapeutic use Female Humans Hypertension / drug therapy*, physiopathology Lisinopril / pharmacology, therapeutic use Male Middle Aged Office Visits* Sodium Chloride Symporter Inhibitors / pharmacology, therapeutic use Tetrazoles / pharmacology, therapeutic use Treatment Outcome Valine / analogs & derivatives, pharmacology, therapeutic use |
| Chemical | |
Reg. No./Substance:
|
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers; 0/Sodium Chloride Symporter Inhibitors; 0/Tetrazoles; 137862-53-4/valsartan; 42399-41-7/Diltiazem; 7004-03-7/Valine; 72509-76-3/Felodipine; 77-36-1/Chlorthalidone; 83915-83-7/Lisinopril |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Lower prevalence of the OCT2 Ser270 allele in patients with essential hypertension.
Next Document: Lead and growth status of school children living in the copper basin of south-western Poland: differ...