Combination Drug Therapy with Calcium‐Channel Blockers in the Treatment of Systemic Hypertension

Frishman, William H.; Landau, Andre J.; Cretkovic, Alexander

doi:10.1002/j.1552-4604.1993.tb05619.x

Cited by 18 publications

(7 citation statements)

References 27 publications

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“…When used in combination with other antihypertensive drugs, CCBs can exhibit a marked BP lowering effect and may induce a too potent hypotensive effect. [29][30] Third, too few ABPM measurements were obtained in this study; therefore, some data points with significant BP changes between these two regimens may have been missed.…”

Section: Discussionmentioning

confidence: 95%

“…[23][24][25][26][27][28][29][30][31][32] Greminger, et al studied the effect of morning versus evening administration of nifedipine gastrointestinal therapeutic system (GITS) in 15 patients with moderate hypertension and concluded that the time of administration of nifedipine GITS had no impact on daytime or nighttime BP control. 25) Mengden, et al reported that different timing of once-daily amlodipine administration does not influence its efficacy for 24-hour BP control.…”

Section: Discussionmentioning

confidence: 99%

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Morning Versus Evening Administration of a Calcium Channel Blocker in Combination Therapy for Essential Hypertension by Ambulatory Blood Pressure Monitoring Analysis

et al. 2005

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SUMMARYPatients with moderate to severe hypertension may need more than two antihypertensive drugs in combination to achieve ideal blood pressure (BP) control. The purpose of this study was to compare the efficacy and safety of administering the antihypertensive agents either all together in the morning or separately with two agents in the morning and one calcium channel blocker (CCB) in the evening. Twenty-four-hour ambulatory BP monitoring (ABPM) was performed among 15 patients (mean, 59 years) with moderate to severe essential hypertension. All patients received at least 3 antihypertensive drugs for ideal BP control. Two treatment regimens were given to each patient: Regimen 1: All antihypertensive agents were given once a day in the morning; Regimen 2: All antihypertensive agents were given in the morning, except the CCB which was given at 4:00 pm. After receiving regimen 1 for 4 weeks, each patient underwent 24-hour ABPM to analyze the BP control. After the first ABPM, each patient was switched to regimen 2. After 4 weeks of treatment with regimen 2, each patient underwent the second ABPM measurement. The pretreatment mean systolic and diastolic BP were 179.6 ± 21.7 and 107.4 ± 19.9 mmHg, respectively. Between the two regimens, there was no significant difference in the mean 24-hour BP (126.1 ± 5.8/73.3 ± 3.8 versus 130.2 ± 6.2/75.1 ± 4.7 mmHg), daytime BP (128.2 ± 6.5/75.3 ± 3.8 versus 132.4 ± 5.8/77.2 ± 4.4 mmHg), nighttime BP (125.2 ± 4.9/72.4 ± 3.3 versus 130.9 ± 6.2/73.8 ± 4.1 mmHg), and 24-hour heart rate (65.1 ± 3.8 versus 64.2 ± 3.4 bpm). The circadian BP and heart rate profiles were almost identical between regimen 1 and regimen 2. We conclude that in patients with moderate to severe hypertension treated with at least 3 antihypertensive agents, administering a CCB simultaneously with other antihypertensive agents in the morning or separately in the evening did not affect the 24-hour BP control. (Int Heart J 2005; 46: 433-442)

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Morning Versus Evening Administration of a Calcium Channel Blocker in Combination Therapy for Essential Hypertension by Ambulatory Blood Pressure Monitoring Analysis

et al. 2005

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“…[1][2][3][4] The vasodilatory oedema occurring with dihydropyridine calcium antagonist is the result of arteriolar dilatation which increases transcapillary pressure. It is in general unresponsive to diuretic therapy since diuretics have little effect on transcapillary pressure.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] The efficacy, tolerability, and safety of combination therapy was evaluated in this randomised, double-blind, placebo-controlled, parallel-group, multicentre trial comparing the combination of amlodipine 5 mg/benazepril 10 mg with amlodipine 5 mg, benazepril 10 mg, and placebo in patients with essential hypertension. azepril 10 mg (P Ͻ 0.001), and placebo (P Ͻ 0.001).…”

Section: Introductionmentioning

confidence: 99%

Once-daily treatment of patients with hypertension: a placebo-controlled study of amlodipine and benazepril vs amlodipine or benazepril alone

Pool

Kaihlanen

Lewis³

et al. 2001

J Hum Hypertens

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Objective: To compare the efficacy, tolerability, and safety of once-daily therapy with amlodipine 5 mg/benazepril 10 mg vs amlodipine 5 mg, benazepril 10 mg, and placebo. Design: Randomised, double-blind, placebo-controlled, parallel-group, multicentre trial. Setting: Twenty-two clinical centres, including private practice groups and academic research clinics. Patients: A total of 530 patients between 21 and 80 years of age with essential hypertension were screened for the study, and 454 were randomised to treatment with amlodipine 5 mg/benazepril 10 mg, amlodipine 5 mg, benazepril 10 mg, or placebo for 8 weeks. Results: Amlodipine 5 mg/benazepril 10 mg produced greater reductions from baseline in sitting diastolic blood pressure than amlodipine 5 mg (P Ͻ 0.03), ben-

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“…Combination therapy, using two or more classes of drugs simultaneously, is one way of escalating treatment, and has been used successfully in the treatment of systemic hypertension and heart failure [9,10]. It is also an attractive option for the management of PAH because three separate signalling pathways known to be involved in the disease are targeted by present therapies: 1) the prostacyclin pathway; 2) the endothelin pathway; and 3) the nitric oxide (NO) pathway.…”

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confidence: 99%

Treat-to-target strategies in pulmonary arterial hypertension: the importance of using multiple goals

Sitbon¹,

Galiè²

2010

European Respiratory Review

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Major advances have occurred in the treatment of pulmonary arterial hypertension (PAH) over the past decade. The advent of PAH-specific pharmacological treatments has offered hope to patients with a debilitating, progressive disease and a poor prognosis. Combined drug treatment offers improved benefits over monotherapy, and current treatment guidelines for PAH recommend a sequential add-on approach to combination therapy for patients in New York Heart Association (NYHA)/World Health Organization functional class (WHO FC) II-IV.Goal-oriented therapy determines the timing of treatment escalation by inadequate response to known prognostic indicators. Close monitoring of patients aids the early identification of inadequate response, so that treatment can be escalated promptly and before the patient's condition deteriorates further. Existing treatment goals are based on baseline values of prognostic indicators, but it is vital to identify risk factors that are both relevant during treatment and that can be assessed during follow-up appointments. Data from different PAH aetiologies indicate that NYHA/WHO FC is the most appropriate prognostic marker, with 6-min walk distance and several haemodynamic parameters representing alternatives.Future refinement of goal-oriented therapy could include the use of multiple prognostic markers, while additional, large clinical trials will answer questions concerning choice and combination of treatment goals.

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Combination Drug Therapy with Calcium‐Channel Blockers in the Treatment of Systemic Hypertension

Cited by 18 publications

References 27 publications

Morning Versus Evening Administration of a Calcium Channel Blocker in Combination Therapy for Essential Hypertension by Ambulatory Blood Pressure Monitoring Analysis

Morning Versus Evening Administration of a Calcium Channel Blocker in Combination Therapy for Essential Hypertension by Ambulatory Blood Pressure Monitoring Analysis

Once-daily treatment of patients with hypertension: a placebo-controlled study of amlodipine and benazepril vs amlodipine or benazepril alone

Treat-to-target strategies in pulmonary arterial hypertension: the importance of using multiple goals

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