Document Detail

Beneficial effects of combination therapy with angiotensin II receptor blocker and angiotensin-converting enzyme inhibitor on vascular endothelial function.
MedLine Citation:
PMID:  18971536     Owner:  NLM     Status:  MEDLINE    
The combination of angiotensin I-converting enzyme inhibitors and angiotensin receptor blockers has been shown to be more effective than the individual drugs alone in the treatment of chronic kidney disease and chronic heart failure. In the present study, we evaluated the effect of treatment with the calcium channel blocker amlodipine or the angiotensin I-converting enzyme inhibitor perindopril on vascular endothelial function and arteriosclerosis in patients with essential hypertension who had already been receiving angiotensin receptor blocker monotherapy. Thirty-two patients with essential hypertension treated with angiotensin receptor blocker monotherapy were randomized to receive 5 mg of amlodipine (n=16) or 4 mg of perindopril (n=16) once daily in the morning for 24 weeks. The patients were evaluated before and after therapy to assess changes in blood pressure, flow-mediated vasodilation (a parameter of vascular endothelial function), and brachial-ankle pulse wave velocity (a parameter of arteriosclerosis). Before treatment, there were no significant differences in the above parameters between groups. After treatment, there was a similar significant decrease in blood pressure in both groups. Flow-mediated vasodilation increased significantly in the perindopril group compared with the amlodipine group; however, the decrease in brachial-ankle pulse wave velocity was not significantly different between groups. In conclusion, these results suggest that the angiotensin I-converting enzyme inhibitor perindopril is superior to the calcium channel blocker amlodipine for reducing vascular endothelial dysfunction when co-administered with angiotensin receptor blockers in patients with essential hypertension.
Satoshi Morimoto; Kei Maki; Yasuko Aota; Takao Sakuma; Toshiji Iwasaka
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  31     ISSN:  0916-9636     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-10-30     Completed Date:  2008-11-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1603-10     Citation Subset:  IM    
Department of Internal Medicine, Ohmihachiman City Hospital, Ohmihachiman, Japan.
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MeSH Terms
Amlodipine / administration & dosage*
Angiotensin II Type 1 Receptor Blockers / administration & dosage*
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Antihypertensive Agents / administration & dosage
Blood Flow Velocity / drug effects
Blood Pressure / drug effects
Calcium Channel Blockers / administration & dosage
Drug Therapy, Combination
Endothelium, Vascular / drug effects*
Heart Rate / drug effects
Hypertension / drug therapy*
Middle Aged
Perindopril / administration & dosage*
Treatment Outcome
Vasodilation / drug effects
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers; 82834-16-0/Perindopril; 88150-42-9/Amlodipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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