Document Detail


Effects of telmisartan and amlodipine in combination on ambulatory blood pressure in stages 1-2 hypertension.
MedLine Citation:
PMID:  20613496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Evaluation of combination therapy with antihypertensive agents by clinic blood pressure (BP) measurements may yield results that differ from out-of-office BP readings. This is of clinical relevance because out-of-office BP values are of prognostic importance. We studied the effects of combining telmisartan and amlodipine on ambulatory BP in patients with stages 1-2 hypertension. METHODS: We conducted an 8-week, placebo-controlled, double-blind, 4x4 factorial design trial in which 562 patients with clinic diastolic BP at least 95 and 119 mmHg or less were randomized to receive telmisartan (0, 20, 40, or 80 mg) and/or amlodipine (0, 2.5, 5, or 10 mg). Ambulatory BP monitoring was performed at baseline and after 8 weeks of treatment; the end points of interest were the changes from baseline in 24-h systolic and diastolic BP. Secondary end points included the proportion of responders (> or =10 mmHg BP reduction from baseline and/or <130/80 mean 24-h BP) and controlled patients (<130/80 mmHg mean 24-h BP). RESULTS: Combination therapies of telmisartan and amlodipine lowered 24-h BP to a larger extent than the corresponding monotherapies at all doses. Mean reductions from baseline in 24-h BP for the combination of the highest doses of telmisartan (80 mg) and amlodipine (10 mg) were -22.4/-14.6 versus -11.9/-6.9 mmHg for amlodipine (10 mg) and -11.0/-6.9 mmHg for telmisartan (80 mg) (P<0.0001 for each comparison). In addition, BP response and control rates (24-h BP <130/80 mmHg) were significantly higher with the combination therapy versus the monotherapy groups. CONCLUSION: These findings show that telmisartan and amlodipine in combination provide substantial 24-h BP efficacy that is superior to either monotherapy in patients with stages 1 and 2 hypertension.
Authors:
William B White; Thomas W Littlejohn; Claudio R Majul; Willie Oigman; Rafael Olvera; Mary Seeber; Helmut Schumacher; Giuseppe Mancia
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  15     ISSN:  1473-5725     ISO Abbreviation:  Blood Press Monit     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-14     Completed Date:  2010-11-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  205-12     Citation Subset:  IM    
Affiliation:
Pat and Jim Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, 06030, USA. wwhite@nso1.uchc.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Amlodipine / administration & dosage,  therapeutic use*
Angiotensin II Type 1 Receptor Blockers / administration & dosage
Antihypertensive Agents / administration & dosage
Benzimidazoles / administration & dosage,  therapeutic use*
Benzoates / administration & dosage,  therapeutic use*
Blood Pressure / drug effects
Blood Pressure Monitoring, Ambulatory
Double-Blind Method
Drug Therapy, Combination
Female
Humans
Hypertension / drug therapy*
Male
Middle Aged
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Benzimidazoles; 0/Benzoates; 144701-48-4/telmisartan; 88150-42-9/Amlodipine

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


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