| Comparison of combination therapies, including the angiotensin receptor blocker olmesartan and either a calcium channel blocker or a thiazide diuretic, in elderly patients with hypertension. | |
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MedLine Citation:
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PMID: 21124326 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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The blood pressure goals set for the treatment of hypertensive patients have been lowered in recent guidelines. To reduce blood pressure levels sufficiently, combination therapies are often needed, but there is little evidence about which combination should be chosen. The present study was carried out to compare the effects of combination therapies, including the angiotensin receptor blocker olmesartan and either a calcium channel blocker (CCB) or a thiazide diuretic, in elderly patients with hypertension. A total of 65 patients aged 65-85 years, with blood pressures of 140/90 mm Hg or higher for those taking antihypertensive medication or 160/100 mm Hg or higher for those not on medication, were randomly assigned to either the group treated with olmesartan plus a dihydropyridine CCB or the group treated with olmesartan plus a thiazide diuretic; 58 patients completed the treatment for 6 months. Systolic and diastolic blood pressures (SBP and DBP) were reduced during the treatment period in both the groups. The reductions in SBP at 1 and 6 months were significantly (P<0.05) greater in the CCB combination group than in the diuretic group (-29 vs. -18 mm Hg, respectively, at 1 month; -32 vs. -23 mm Hg, respectively, at 6 months). Despite greater reduction in SBP in the CCB group, the serum creatinine level and the estimated glomerular filtration rate (eGFR) remained unchanged, whereas in the diuretic group, creatinine was elevated (+0.06 mg per 100 ml, P<0.05) and eGFR was reduced (-4.5 ml min(-1) per 1.73 m(2)). In addition, high-density lipoprotein cholesterol levels were reduced in the diuretic group (-5.0 mg per 100 ml, P<0.01). These results suggest that olmesartan plus a CCB is the preferable combination therapy in comparison with olmesartan plus a thiazide diuretic for elderly patients with hypertension. |
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Authors:
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Johji Kato; Naoto Yokota; Noboru Tamaki; Sumito Kariya; Toshihiro Kita; Takao Ayabe; Tanenao Eto; Kazuo Kitamura |
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Publication Detail:
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Type: Journal Article Date: 2010-12-02 |
Journal Detail:
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Title: Hypertension research : official journal of the Japanese Society of Hypertension Volume: 34 ISSN: 1348-4214 ISO Abbreviation: Hypertens. Res. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9307690 Medline TA: Hypertens Res Country: England |
Other Details:
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Languages: eng Pagination: 331-5 Citation Subset: IM |
Affiliation:
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Frontier Science Research Center, University of Miyazaki, Miyazaki, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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