Document Detail

How can hypertensive patients be better treated? The contribution of combination therapy.
MedLine Citation:
PMID:  10854046     Owner:  NLM     Status:  MEDLINE    
Recent studies demonstrated that target blood pressure (BP) in treated hypertensive patients should be below 140 mmHg for systolic blood pressure (SBP) and below 90 mmHg for diastolic blood pressure (DBP). However, population studies from several countries have demonstrated that in clinical practice the proportion of controlled hypertensive patients is less than 30%. In order to elucidate these questions in France we analysed a large population of 145,000 subjects examined at the Centre d'Investigations Préventives et Cliniques in Paris (IPC). Among those with high BP at the time of their IPC visit, only 20% received an antihypertensive treatment. Among those receiving an antihypertensive treatment, less than 27% (24% in men and 30% in women) presented with BP values less than 140 mmHg for SBP and less than 90 mmHg for DBP. This analysis also showed that 72% of hypertensive patients presented with at least one modifiable associated cardiovascular risk factor and that more than 30% of hypertensive men and more than 25% of hypertensive women presented with at least two associated risk factors. The use of combination therapies could help to increase the percentage of well-controlled hypertensive subjects. It has been shown that in order to reach this BP level, combination therapy should be used in more than two-thirds of the treated subjects. The trandolapril-verapamil combination is the first fixed combination of an angiotensin-converting enzyme inhibitor and a non-dihydropyridine calcium-channel blocker. Administered once daily, this combination reduces BP more than a classic monotherapy. The effects of the trandolapril-verapamil combination on risk factors are either neutral (metabolic parameters), or even beneficial (reduction in heart rate).
A Benetos; L Guize; A Rudnichi; M Safar; R Asmar; K Bean
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  35 Suppl 3     ISSN:  0160-2446     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  2000  
Date Detail:
Created Date:  2000-09-05     Completed Date:  2000-09-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S13-16     Citation Subset:  IM    
INSERM U337 and Centre d'Investigations Préventives et Cliniques, Paris, France.
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MeSH Terms
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Calcium Channel Blockers / therapeutic use*
Cohort Studies
Drug Therapy, Combination
Hypertension / drug therapy*,  epidemiology
Indoles / therapeutic use*
Middle Aged
Risk Factors
Verapamil / therapeutic use*
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Calcium Channel Blockers; 0/Indoles; 52-53-9/Verapamil; 87679-37-6/trandolapril

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

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