The antihypertensive efficacy and tolerability of a low dose combination of ramipril and felodipine ER in mild to moderate essential hypertension

Abstract

The antihypertensive efficacy and tolerability of a low dose combination of the angiotensin converting enzyme inhibitor ramipril (2.5 mg) and the extended release formulation of the dihydropyridine calcium channel antagonist felodipine (5 mg) were assessed in a double‐blind, double dummy placebo controlled, randomised, crossover study in 20 patients (mean age 55.4 years; range 46–69) with uncomplicated mild to moderate hypertension (supine diastolic >90 mmHg <115 mmHg after 4 weeks of single‐blind wash‐out on placebo). The four randomised, double‐blind, crossover study phases evaluated the response to 4 weeks of once daily treatment with placebo, monotherapy with each drug and the combination. Noninvasive ambulatory blood pressure monitoring (Spacelabs 90207) was performed for 24 h at the end of each phase. The mean 24 h ambulatory blood pressure (mmHg) was 147.9/92.0 following placebo, 141.3/87.8 following monotherapy with ramipril 2.5 mg, 136.8/85.8 following monotherapy with felodipine ER 5 mg and 131.1/82.6 following the combination of ramipril 2.5 mg and felodipine ER 5 mg. All active treatment phases significantly reduced mean 24 h ambulatory diastolic pressure by comparison with placebo. The antihypertensive efficacy of the combination was additive. The coadministration of ramipril did not attenuate the incidence of headache attributable to felodipine ER.

Comparison of Efficacy and Adverse Drug Reactions of Monotherapy Versus Combination Therapy of Antihypertensives Among Diabetic Hypertensive Patients in a Tertiary Care Hospital

“…This finding was consistent with earlier studies wherein the ACE inhibitor + CCB group showed a greater percentage reduction (21.8%) in comparison to the other 2-drug combination groups [20,[36][37][38]. In our study, we found a greater percentage decrease in DBP with ARB + CCB and beta blocker + CCB group (12.5%).…”

Nifedipine versus carvedilol in the treatment ofde novoarterial hypertension after liver transplantation: Results of a controlled clinical trial

“…The second result of this study is that only 19% of partial responders to monotherapy (with nifedipine or carvedilol) have good control of blood pressure with combined therapy, in which an ACE inhibitor is added to the first chosen drug. In the treatment of essential hypertension, in fact, the efficacy of the ACE inhibitors is 45%–71%29 when they are used in monotherapy and >70%30 when they are added to other antihypertensive drugs. These data seem to confirm that the activation of the renin‐angiotensin system is not an important mechanism underlying CNI‐related arterial hypertension.…”

Modern antihypertensive therapy: the effectiveness of a unique Russian fixed-dose combination of ramipril and indapamide

“…приводил к эффективному снижению как систолического, так и диастолического АД, а также достижению желаемого уровня АД у 50-70% больных [24,[27][28][29]. В тех случаях, когда монотерапия рамиприлом не приводила к достаточному снижению АД, антигипертензивный эффект можно значительно увеличить за счет сочетанного приема с диуретиками или другими АГП [30][31][32][33]. Результаты нескольких исследований свидетельствуют об эффективности применения рамиприла для уменьшения гипертрофии миокарда левого желудочка (ГЛЖ).…”