Primula Multimedia S.R.L., Pisa, Italy.
J Nephrol. 2011 Jul-Aug;24(4):428-37. doi: 10.5301/JN.2011.6271.
Even with the availability of novel and efficacious antihypertensive agents, an insufficient number of hypertensive patients achieve their desired blood pressure (BP) target. This failure is partly due to the fact that many patients do not strictly adhere to their drug therapy and/or they report the presence of adverse effects. Traditionally, monotherapy is used as first-line treatment to achieve BP targets; however, when this fails, combination therapy is then required. In light of the need to attain BP goals, combination therapy (especially fixed-dose) is currently recommended. The main advantages of combination therapy over monotherapy are not only that of reduced dose, improved efficacy and reduced adverse effects, but also of target protection and reduced cardiovascular (CV) risk. Therefore, the development of single-administration drug combinations should also improve patient adherence to therapy and therefore help in achieving BP control. Among the various combinations available, calcium channel blockers (CCBs) and angiotensin-converting enzyme (ACE) inhibitors have been proven to be extremely effective, while also displaying good tolerability. Individually, both the third-generation CCB lercanidipine and the ACE inhibitor enalapril are effective antihypertensive agents. In addition, both of these agents also show other beneficial effects when administered as monotherapy. Of particular importance is the fact that when lercanidipine plus enalapril are administered in combination, they show synergism, thus providing added efficacy with reduced side effects. The present report provides an overview of the main clinical studies examining lercanidipine and enalapril administered as monotherapy, with particular focus on the potential renoprotective effects afforded by the fixed-dose combination lercanidipine-enalapril.
即使有新型且有效的抗高血压药物可用，仍有相当数量的高血压患者无法达到其理想的血压（BP）目标。这种失败部分归因于许多患者没有严格遵守药物治疗，或报告存在不良反应。传统上，单药治疗被用作实现 BP 目标的一线治疗；然而，当这种方法失败时，就需要联合治疗。鉴于需要达到 BP 目标，目前推荐联合治疗（尤其是固定剂量）。联合治疗相对于单药治疗的主要优势不仅在于减少剂量、提高疗效和减少不良反应，还在于保护靶器官和降低心血管（CV）风险。因此，开发单次给药的药物组合也应提高患者对治疗的依从性，从而有助于控制血压。在现有的各种组合中，钙通道阻滞剂（CCB）和血管紧张素转换酶（ACE）抑制剂已被证明非常有效，同时也具有良好的耐受性。单独使用第三代 CCB 乐卡地平或 ACE 抑制剂依那普利都是有效的抗高血压药物。此外，这两种药物作为单药治疗也具有其他有益的作用。特别重要的是，当乐卡地平与依那普利联合使用时，它们显示出协同作用，从而提供了增效减毒的效果。本报告概述了检查乐卡地平与依那普利作为单药治疗的主要临床研究，特别关注固定剂量组合乐卡地平-依那普利提供的潜在肾脏保护作用。
