Document Detail

Combination therapy of angiotensin II receptor blocker and calcium channel blocker exerts pleiotropic therapeutic effects in addition to blood pressure lowering: amlodipine and candesartan trial in Yokohama (ACTY).
MedLine Citation:
PMID:  22571446     Owner:  NLM     Status:  MEDLINE    
Recent guidelines recommend combination antihypertensive therapy to achieve the target blood pressure (BP) and to suppress target organ damage. This study aimed to examine the beneficial effects of combination therapy with candesartan and amlodipine on BP control and markers of target organ function in Japanese essential hypertensive patients (N = 20) who did not achieve the target BP level during the monotherapy period with either candesartan or amlodipine. After the monotherapy period, for patients already being treated with amlodipine, a once-daily 8 mg dose of candesartan was added on during the combination therapy period (angiotensin II receptor blocker [ARB] add-on group, N = 10), and a once-daily 5 mg dose of amlodipine was added on for those already being treated with candesartan (calcium channel blocker [CCB] add-on group, N = 10). Combination therapy with candesartan and amlodipine for 12 weeks significantly decreased clinic and home systolic blood pressure (SBP) and diastolic blood pressure (DBP). In addition, the combination therapy was able to significantly reduce urine albumin excretion without decrease in estimated glomerular filtration ratio and resulted in significant improvements in brachial-ankle pulse wave velocity, central SBP, and insulin sensitivity. Furthermore, the CCB add-on group showed a significantly greater decrease in clinic and home DBP than the ARB add-on group. The calcium channel blocker add-on group also exhibited better improvements in vascular functional parameters than the ARB add-on group. These results suggest that combination therapy with candesartan and amlodipine is an efficient therapeutic strategy for hypertension with pleiotropic benefits.
Akinobu Maeda; Kouichi Tamura; Tomohiko Kanaoka; Masato Ohsawa; Sona Haku; Kengo Azushima; Toru Dejima; Hiromichi Wakui; Mai Yanagi; Yasuko Okano; Tetsuya Fujikawa; Yoshiyuki Toya; Shunsaku Mizushima; Osamu Tochikubo; Satoshi Umemura
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-05-09
Journal Detail:
Title:  Clinical and experimental hypertension (New York, N.Y. : 1993)     Volume:  34     ISSN:  1525-6006     ISO Abbreviation:  Clin. Exp. Hypertens.     Publication Date:  2012  
Date Detail:
Created Date:  2012-06-11     Completed Date:  2012-10-09     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  9305929     Medline TA:  Clin Exp Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  249-57     Citation Subset:  IM    
Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
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MeSH Terms
Albuminuria / drug therapy
Amlodipine / administration & dosage*
Angiotensin II Type 1 Receptor Blockers / administration & dosage*
Antihypertensive Agents / administration & dosage*
Benzimidazoles / administration & dosage*
Blood Pressure* / drug effects
Calcium Channel Blockers / administration & dosage*
Creatinine / urine
Drug Therapy, Combination
Glomerular Filtration Rate / drug effects
Hypertension / drug therapy*,  physiopathology
Insulin Resistance
Middle Aged
Tetrazoles / administration & dosage*
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Benzimidazoles; 0/Calcium Channel Blockers; 0/Tetrazoles; 60-27-5/Creatinine; 88150-42-9/Amlodipine; S8Q36MD2XX/candesartan

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

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