Miura S, Saku K
Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
J Int Med Res. 2012;40(1):1-9. doi: 10.1177/147323001204000101.
Adequate lowering of blood pressure reduces the risk of hypertension-induced cardiovascular events. Worldwide, blood pressure is not optimally controlled and more effective management is needed. The efficacy and tolerability of angiotensin II type 1 receptor blockers (ARBs) have led to their widespread use. Calcium channel blockers (CCBs) are highly effective antihypertensives and amlodipine has a long half-life in the circulation. The combination of an ARB with a CCB as a single-pill, fixed-dose treatment is emerging as possibly the best therapy for preventing cardiovascular disease. Although many kinds of ARB are used in such combinations, amlodipine is mainly used as the CCB. Thus, differences in safety and efficacy among single-pill ARB/CCBs depend mainly on the ARB. Not all ARBs have the same effects and some of these may be molecular (or differential) rather than class (or common) effects. This review discusses the safety and efficacy of ARB/CCB combination therapy, with particular focus on a single-pill, fixed-dose combination of valsartan/amlodipine.
充分降低血压可降低高血压所致心血管事件的风险。在全球范围内,血压并未得到最佳控制,需要更有效的管理。血管紧张素II 1型受体阻滞剂(ARB)的疗效和耐受性已使其得到广泛应用。钙通道阻滞剂(CCB)是高效的抗高血压药物,氨氯地平在循环中有较长的半衰期。ARB与CCB联合作为单片固定剂量治疗正逐渐成为预防心血管疾病的最佳治疗方法。虽然有多种ARB用于此类联合治疗,但CCB主要使用氨氯地平。因此,单片ARB/CCB之间的安全性和疗效差异主要取决于ARB。并非所有ARB都有相同的作用,其中一些可能是分子(或差异)效应而非类别(或共同)效应。本综述讨论了ARB/CCB联合治疗的安全性和疗效,特别关注缬沙坦/氨氯地平单片固定剂量联合治疗。