Efficacy of olmesartan/amlodipine combination therapy in reducing ambulatory blood pressure in moderate-to-severe hypertensive patients not controlled by amlodipine alone

Abstract

This previously unpublished, preplanned analysis investigated the efficacy of the olmesartan/amlodipine combination at different doses on 24-h blood pressure (BP) control, as well as assessed trough estimation of trough-to-peak ratio (TPR) and smoothness index (SI). Ambulatory BP monitoring was performed in patients with moderate-to-severe hypertension whose BP was inadequately controlled after 8 weeks' treatment with amlodipine 5 mg. Patients were randomized to continue with amlodipine 5 mg or to receive olmesartan/amlodipine 10/5, 20/5 or 40/5 mg for 8 weeks (Period II). Patients not achieving BP control were uptitrated to a more powerful regimen for another 8 weeks (Period III). During Period II, each olmesartan/ amlodipine combination reduced 24-h systolic and diastolic BP (SBP/DBP), as well as morning and early morning SBP/DBP, significantly more than amlodipine 5 mg (Po0.001 for all). TPRs were higher in each olmesartan/amlodipine group than with amlodipine 5 mg, and SI values showed dose-related increases; olmesartan/amlodipine 40/5 mg produced a significantly higher SI for SBP and DBP (1.55 and 1.33, respectively) than amlodipine 5 mg (0.96 and 0.77, respectively, Po0.0001 for each). During Period III, uptitrated patients showed further BP reductions, which were largest in those on olmesartan/amlodipine 40/10 mg. SI values increased in uptitrated patients and were highest with olmesartan/amlodipine 40/10 mg (SBP 1.62/DBP 1.41). The olmesartan/amlodipine combination effectively reduces BP over 24 h, including the morning hours, in a dose-related manner. Compared with amlodipine alone, the olmesartan/amlodipine combination has a better 24-h coverage (TPR) and a dose-related improvement in BP lowering homogeneity (SI).

Evening versus morning dosing of antihypertensive drugs in hypertensive patients with sleep apnoea

“…Nevertheless, it is unknown whether the benefits of evening dosing in OSA patients also apply to other drugs of the same class or other classes and combinations. In particular, further studies may evaluate whether similar results can be obtained with angiotensin receptor blockers characterized by a longer duration of action than valsartan, which have been shown to more smoothly control 24-h BP, such as telmisartan [27] or olmesartan [28].…”

Management of morning hypertension: a consensus statement of an Asian expert panel

“…Irrespective of treatment regimen, reduction in morning BP was associated with a significant reduction in urinary albumin excretion . In another randomized, double‐blind, parallel group study (n = 626), the combination of olmesartan/amlodipine was more effective in reducing BP over 24 hours, including the early morning and whole morning hours than those who were not adequately controlled with amlodipine monotherapy ( P < .0001) . In a Japanese study of 263 patients with diabetes mellitus who were refractory to standard dose of angiotensin receptor blocker therapy, combination therapy of amlodipine/olmesartan reduced morning BP compared with high‐dose angiotensin receptor blocker monotherapy …”

“…Even long‐acting drugs, used as combination therapy, may increase morning BP control with full doses. In a dose comparison study of amlodipine/olmesartan combination, the 10/40 mg full‐dose combination had the highest BP control over 24 hours and in the morning …”

“…Data were obtained from Wikipedia (accessed July 18, 2017). monotherapy (P < .0001) 36. In a Japanese study of 263 patients with diabetes mellitus who were refractory to standard dose of angiotensin receptor blocker therapy, combination therapy of amlodipine/olmesartan reduced morning BP compared with high-dose angiotensin receptor blocker monotherapy 39.…”

Comparative analysis of several methods for blood pressure measurement in the morning in patients with arterial hypertension

“…Новый метод сочетает в себе некоторые качества скоростных и абсолютных характеристик утренних АД, не обладая субъективизмом, который неизбежен при использовании дневника пациента, характеризуется высоким уровнем воспроизводимости и валидности. В качестве удачного примера выделения ВП в утренние часы можно привести работу [14], в которой разбили кривую суточной динамики АД на фиксированные интервалы времени: с 4:00 до 7:00 ч (обозначены как ранние утренние часы) и с 8:00 до 12:00 ч (утренние часы).…”