Littlejohn Thomas W, Majul Claudio R, Olvera Rafael, Seeber Mary, Kobe Maureen, Guthrie Robert, Oigman Wille
Piedmont Medical Research Associates, Winston-Salem, NC, USA.
J Clin Hypertens (Greenwich). 2009 Apr;11(4):207-13. doi: 10.1111/j.1751-7176.2009.00098.x.
This randomized 4 x 4 factorial study determined the efficacy and safety of telmisartan (T) plus amlodipine (A) in hypertensive patients. Adults (N=1461) with stage 1 or 2 hypertension (baseline blood pressure [BP]: 153.2[12.1]/101.7[4.3] mm Hg) were randomized to 1 of 16 treatment groups with T 0, 20, 40, 80 mg and A 0, 2.5, 5, 10 mg for 8 weeks. In-clinic BP reductions were greater with combination therapy than respective monotherapies. The greatest least-square mean systolic/diastolic BP reductions were observed with T80 mg plus A10 mg (-26.4/-20.1 mm Hg; P<.05 compared with both monotherapies). BP control was also greatest in the T80-mg plus A10-mg group (76.5% [overall control] and 85.3% [diastolic BP control]), and BP response rates >90% with this combination. Peripheral edema was most common in the A10-mg group (17.8%); however, this rate was notably lower when A was used in combination with T: 11.4% (T20/A10), 6.2% (T40/A10), and 11.3% (T80/A10).
这项随机4×4析因研究确定了替米沙坦(T)联合氨氯地平(A)治疗高血压患者的疗效和安全性。1461例1或2期高血压成人患者(基线血压[BP]:153.2[12.1]/101.7[4.3] mmHg)被随机分为16个治疗组中的1组,分别接受替米沙坦0、20、40、80 mg和氨氯地平0、2.5、5、10 mg治疗8周。联合治疗的门诊血压降幅大于各自的单药治疗。替米沙坦80 mg加氨氯地平10 mg组的收缩压/舒张压降幅最大(-26.4/-20.1 mmHg;与两种单药治疗相比,P<0.05)。替米沙坦80 mg加氨氯地平10 mg组的血压控制率也最高(总体控制率为76.5%,舒张压控制率为85.3%),该联合用药的血压反应率>90%。外周水肿在氨氯地平10 mg组最为常见(17.8%);然而,当氨氯地平与替米沙坦联合使用时,这一比例显著降低:替米沙坦20 mg/氨氯地平10 mg组为11.4%,替米沙坦40 mg/氨氯地平10 mg组为6.2%,替米沙坦80 mg/氨氯地平10 mg组为11.3%。