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缬沙坦80毫克加氨氯地平5毫克单片复方制剂治疗单药治疗血压控制不佳的轻至中度原发性高血压患者的疗效和安全性

[Efficacy and safety of the single pill combination of valsartan 80 mg plus amlodipine 5 mg in mild to moderate essential hypertensive patients without adequate blood pressure control by monotherapy].

作者信息

Ke Yuan-Nan, Huang Jun, Zhu Jun-Ren

机构信息

Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Sep;37(9):794-9.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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