Title: Comparison of two combination regimens in the treatment of mild to moderate essential hypertension
Abstract: Objective: To compare antihypertensive effects of two combination regimens in the treatment of mild to moderate essential hypertension. Methods:60 patients with mild and moderate hypertension were randomly assigned to one of two treatment groups. All patients orally received irbesartan 150 mg daily for 4 weeks immediately after a 2-week wash-out period, and subsequently administered either the combination of irbesartan 150 mg with felodipine 5 mg (n =27) or with ramipril 5 mg (n = 33) daily for additional 4 weeks. The sitting blood pressure and the 24-hour ambulatory BP monitoring (ABPM) were monitored at 0, 4 and 8 weeks of the therapy. Results: In the secondary 4-week course of therapy, the total response rates of the sitting BP for felodipine- and ramipril-treated patients were increased by 88. 9% and 69. 7% from 48. 1% and 33. 3% ; Of 14 patients who were not responding to irbesartan in the first 4-week course of therapy and were then randomized to the combination of irbesartan and felodipine, 10 patients (71.4% ) experienced dominant effects, 2 (14. 3% ) had effects and 2 (14. 3% ) showed no effects in the improvement of sitting BP in the secondary 4-week course of therapy. Of 22 patients who were not responding to irbesartan in the first 4-week course of therapy and were then randomized to the combination of irbesartan and ramipril, 11 patients (50. 0% ) had dominant effects, 2 (9. 1% ) showed effects and 9 (40. 9% ) gave no effects in the sitting BP in the secondary 4-week course of therapy; the P values in both treatment groups showed no significant difference by Ridit analysis ( P 0. 05). Patients who had no respondance to the ABPM in the first 4-week of therapy showed effect rate of 66. 7% vs. 36. 4% and no effect rate of 33. 3% vs. 63. 6% in the felodipine and ramipril groups in the secondary 4-week course of therapy; the P values of both combination regimens showed a statistical difference by the x2 test (P 0. 05). The smoothness index of SBP and DBP was (0. 68±0. 70) vs. (0. 56±0. 78 ) in the felodipine group and (0. 64±0. 72) vs. (0. 70±0. 69) in the ramipril group, (P 0. 05). Conclusion: The combination of irbesartan with felodipine or ramipril showed synergist antihypertensive effects. Moreover, the combination of irbesartan with felodipine was superior to the combination of irbesartan with ramipril in the control of blood pressure.
Publication Year: 2006
Publication Date: 2006-01-01
Language: en
Type: article
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Cited By Count: 1
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