Effects of Manidipine/Delapril versus Olmesartan/Hydrochlorothiazide Combination Therapy in Elderly Hypertensive Patients with Type 2 Diabetes Mellitus

Fogari, Roberto; Derosa, Giuseppe; Zoppi, Annalisa; Rinaldi, Andrea; Preti, Paola; Lazzari, Pierangelo; Mugellini, Amedeo

doi:10.1291/hypres.31.43

Cited by 22 publications

(19 citation statements)

References 52 publications

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“…15,16,[34][35][36][37][38][39][40][41][42][43] Numerous studies have reported the incidence of peripheral edema in patients receiving combined treatment with a CCB and a RAAS inhibitor versus an alternate regimen (Table 3). 12,[15][16][17][35][36][37][38][39][40][41][42][43][44][45][46][47][48] The combination of a CCB and RAAS blocker has been shown in many studies to be associated with a lower rate of peripheral edema than monotherapy with the same dose of CCB (Table 3). Amlodipine besylate is the most frequently prescribed CCB in clinical practice.…”

Section: Calcium Channel Blocker-induced Lower Extremity Edemamentioning

confidence: 99%

Managing Peripheral Edema in Patients With Arterial Hypertension

Epstein¹,

Roberts²

2009

American Journal of Therapeutics

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Calcium channel blockers (CCBs) play a vital role in the management of hypertension. Peripheral edema is the most common side effect reported with CCB monotherapy, especially with high-dose dihydropyridine CCBs. CCB-related peripheral edema is a dose-limiting effect that is usually medically benign but can compromise patient adherence. CCB-related peripheral edema may cause considerable discomfort and patient concern. Patients presenting with peripheral edema should undergo assessment for drug and nondrug causes. Rather than lowering the CCB dose or switching to another monotherapy, combination therapy (e.g, CCB plus a renin-angiotensin-aldosterone system inhibitor) can enhance blood pressure control, generally with lower doses of individual agents, and lessen the risk of adverse events. As recommended by consensus guidelines, addition of a renin-angiotensin-aldosterone system inhibitor as part of combination therapy may accelerate the time to goal blood pressure as well as help alleviate peripheral edema in affected patients. Successful management of CCB-related peripheral edema with lifestyle changes and rational combination therapy is likely to improve blood pressure control and patient outcomes.

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Section: Calcium Channel Blocker-induced Lower Extremity Edemamentioning

confidence: 99%

Managing Peripheral Edema in Patients With Arterial Hypertension

Epstein¹,

Roberts²

2009

American Journal of Therapeutics

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“…Some clinical studies have demonstrated that olmesartan has organ-protecting effects, including long-term renoprotection in patients with type 2 diabetes, and beneficial effects to reduce cardiovascular risk in patients with atherosclerosis [11,12]. A few clinical studies reported the effect of olmesartan on lipid metabolism [13-15]. However, their subjects were patients who were treated with olmesartan combined with other antihypertensive drugs or lipid-lowering drugs.…”

Section: Introductionmentioning

confidence: 99%

Comparative effect of olmesartan and candesartan on lipid metabolism and renal function in patients with hypertension: a retrospective observational study

Nishida

Takahashi

Nakayama

et al. 2011

Cardiovasc Diabetol

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BackgroundAngiotensin II receptor blockers (ARBs), including olmesartan and candesartan, are widely used antihypertensive agents. Many clinical studies have demonstrated that ARBs have organ-protecting effects, e.g., cardioprotection, vasculoprotection and renoprotection. However, the effect of prolonged olmesartan monotherapy on lipid metabolism in patients with hypertension is less well studied. We performed a retrospective observational study to compare the effects of olmesartan with those of candesartan, focusing on lipid metabolism and renal function.MethodsWe used data from the Clinical Data Warehouse of Nihon University School of Medicine obtained between Nov 1, 2004 and Feb 28, 2011, to identify cohorts of new olmesartan users (n = 168) and candesartan users (n = 266). We used propensity-score weighting to adjust for differences in all covariates (age, sex, comorbid diseases, previous drugs) between olmesartan and candesartan users, and compared serum chemical data including serum triglyceride (TG), LDL-cholesterol (LDL-C), total cholesterol (TC), potassium, creatinine and urea nitrogen. The mean exposure of olmesartan and candesartan users was 126.1 and 122.8 days, respectively.ResultsAfter adjustment, there were no statistically significant differences in all covariates between olmesartan and candesartan users. The mean age was 60.7 and 61.0 years, and 33.4% and 33.7% of olmesartan and candesartan users were women, respectively. There were no statistically significant differences in mean values for all laboratory tests between baseline and during the exposure period in both olmesartan and candesartan users. In olmesartan users, the reduction of serum TG level was significant in comparison with that in candesartan users. Other parameters of lipid profile and renal function showed no statistically significant difference in the change from baseline to during the exposure period between olmesartan and candesartan users.ConclusionsIn this study, we observed a more beneficial effect on lipid metabolism, a reduction of serum TG, with olmesartan monotherapy than with candesartan monotherapy. However, there were no clinically significant changes in the levels of all test parameters between baseline and during the exposure period with both drugs. These results suggest that the influence of olmesartan or candesartan monotherapy on lipid metabolism and renal function is small, and that they can be safely used in patients with hypertension.

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“…[52] Overall, a large proportion of patients showed a DBP response with lowdose olmesartan. [54] In a combined analysis of data from two multi-factorial, dose-ranging studies of adult patients (n = 1986) with moderate- Ball et al [43] Kereiakes et al [56] Mallion et al [57] Ball et al [43] Kereiakes et al [56] Mallion et al [57] Fogari et al [58] Fig. Similar results were observed in a study of patients randomized to varying doses of olmesartan HCTZ or to the corresponding monotherapies.…”

Section: Olmesartan In Combination With Hydrochlorothiazide Versus Comentioning

confidence: 59%

Olmesartan Medoxomil

Mancia¹

2010

High Blood Pressure & Cardiovascular Prevention

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Effects of Manidipine/Delapril versus Olmesartan/Hydrochlorothiazide Combination Therapy in Elderly Hypertensive Patients with Type 2 Diabetes Mellitus

Cited by 22 publications

References 52 publications

Managing Peripheral Edema in Patients With Arterial Hypertension

Managing Peripheral Edema in Patients With Arterial Hypertension

Comparative effect of olmesartan and candesartan on lipid metabolism and renal function in patients with hypertension: a retrospective observational study

Olmesartan Medoxomil

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