Ke Yuan-Nan, Huang Jun, Zhu Jun-Ren
Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Sep;37(9):794-9.
To evaluate the efficacy and safety of a once daily valsartan/amlodipine 80/5 mg combination tablet in Chinese mild to moderate hypertensive patients without adequate blood pressure control by monotherapy.
Two multicenter, randomized, double-blind, double dummy, active-controlled, parallel group trials were conducted. After a washout period (no medication) of 1-4 weeks, patients with Mean Sitting Diastolic Blood Pressure (MSDBP) > or = 95 mm Hg (1 mm Hg = 0.133 kPa) and < 110 mm Hg received a monotherapy of either Amlodipine 5 mg (in study 1) or valsartan 80 mg (in study 2) for 4 weeks. Patients with MSDBP > or = 90 mm Hg and < 110 mm Hg at the end of the monotherapy period were randomized to receive valsartan/amlodipine 80/5 mg treatment, or continue with the monotherapy.
In study 1, compared with amlodipine 5 mg, valsartan/amlodipine 80/5 mg once daily further reduced mean sitting systolic blood pressure (MSSBP)/MSDBP 4.4/3 mm Hg (P < 0.0001). In study 2, compared with valsartan 80 mg, valsartan/amlodipine 80/5 mg once daily further reduced MSSBP/MSDBP 6.4/4.2 mm Hg (P < 0.0001). The blood pressure (BP) control rates (BP < 140/90 mm Hg) of combination treatment group were 71.0% and 71.2% respectively, and significantly higher than the monotherapy groups in both trials. Incidence of adverse events was comparable in monotherapy and combination therapy groups.
Our results showed that valsartan/amlodipine 80/5 mg was superior to amlodipine 5 mg or valsartan 80 mg alone in lowering blood pressure and BP control in patients with mild to moderate hypertension not adequately controlled with amlodipine 5 mg or valsartan 80 mg monotherapy. No new or unexpected safety issues were identified with valsartan/amlodipine combination therapy compared with monotherapy.
评估缬沙坦/氨氯地平80/5mg复方片剂每日一次给药,对单药治疗血压控制不佳的中国轻中度高血压患者的疗效和安全性。
进行了两项多中心、随机、双盲、双模拟、活性药物对照、平行组试验。在1-4周的洗脱期(不服药)后,平均坐位舒张压(MSDBP)≥95mmHg(1mmHg = 0.133kPa)且<110mmHg的患者接受氨氯地平5mg(研究1)或缬沙坦80mg(研究2)单药治疗4周。单药治疗期结束时MSDBP≥90mmHg且<110mmHg的患者被随机分配接受缬沙坦/氨氯地平80/5mg治疗,或继续单药治疗。
在研究1中,与氨氯地平5mg相比,缬沙坦/氨氯地平80/5mg每日一次进一步降低平均坐位收缩压(MSSBP)/MSDBP 4.4/3mmHg(P<0.0001)。在研究2中,与缬沙坦80mg相比,缬沙坦/氨氯地平80/5mg每日一次进一步降低MSSBP/MSDBP 6.4/4.2mmHg(P<0.0001)。联合治疗组的血压(BP)控制率(BP<140/9)分别为71.0%和71.2%,在两项试验中均显著高于单药治疗组。单药治疗组和联合治疗组不良事件的发生率相当。
我们的结果表明,对于使用氨氯地平5mg或缬沙坦80mg单药治疗血压控制不佳的轻中度高血压患者,缬沙坦/氨氯地平80/5mg在降低血压和控制血压方面优于氨氯地平5mg或缬沙坦80mg单药治疗。与单药治疗相比,缬沙坦/氨氯地平联合治疗未发现新的或意外的安全问题。