Efficacy and safety of various combination therapies based on a calcium antagonist in essential hypertension: results of a placebo-controlled randomized trial

Details

Serval ID
serval:BIB_28070DF0B056
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Efficacy and safety of various combination therapies based on a calcium antagonist in essential hypertension: results of a placebo-controlled randomized trial
Journal
Journal of Cardiovascular Pharmacology
Author(s)
Luscher  T. F., Waeber B.
ISSN
0160-2446
Publication state
Published
Issued date
1993
Peer-reviewed
Oui
Volume
21
Number
2
Pages
305-9
Language
english
Notes
Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Abstract
We tested the efficacy and safety of different combination therapies in hypertensive patients with uncontrolled blood pressure (BP) on a monotherapy with a calcium antagonist: 1,647 hypertensive patients were enrolled to receive placebo for 4 weeks followed by isradipine (ISR) 2.5 mg twice daily (b.i.d.) for 4 weeks. Nonresponders [diastolic BP (DBP) > 90 mm Hg] were randomly assigned to receive either the beta-blocker bopindolol 0.5 or 1 mg/day, the diuretic metolazone 1.25 or 2.5 mg/day, the angiotensin-converting enzyme (ACE) inhibitor enalapril 10 or 20 mg/day, ISR 5 mg b.i.d., or placebo. One hundred seventy-five receiving placebo dropped out; 93% (n = 1,376) of the 1,472 patients finished 4-week monotherapy with ISR. Sixty percent (n = 826) reached target BP, and 40% (n = 550) remained uncontrolled and were randomized. Regardless of dosage, all drugs led to a comparable reduction in BP except for the lower dosage of bopindolol and ISR 5 mg b.i.d., which were less effective in lowering systolic BP (SBP). The BP decrease achieved by combination therapy ranged from 10 to 15 mm Hg SBP and from 7 to 11 mm Hg DBP but remained unchanged with placebo. Side effects were minor, and only 2.4% of patients discontinued therapy because of side effects. The side-effect score for edema was lower with ISR plus diuretics than with other combinations, whereas the ACE inhibitor was associated with a higher score for cough. Monotherapy with a calcium antagonist normalizes BP in about two-thirds of patients when used in general practice.(ABSTRACT TRUNCATED AT 250 WORDS)
Keywords
Adrenergic beta-Antagonists/adverse effects/therapeutic useAgedCalcium Channel Blockers/adverse effects/*therapeutic useDouble-Blind MethodDrug Therapy, CombinationEnalapril/adverse effects/therapeutic useFemaleHumansHypertension/*drug therapy/physiopathologyIsradipine/adverse effects/therapeutic useMaleMetolazone/adverse effects/therapeutic useMiddle AgedPindolol/adverse effects/analogs & derivatives/therapeutic use
Pubmed
Web of science
Create date
04/03/2009 15:05
Last modification date
20/08/2019 13:07
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