Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Int J Cardiol. 2013 Sep 1;167(5):2024-30. doi: 10.1016/j.ijcard.2012.05.039. Epub 2012 May 28.
A majority of hypertensives require treatment with ≥2 antihypertensive therapies to achieve blood pressure (BP) goals. Single-pill combinations (SPC) may improve convenience and adherence to therapy and reduce health care resource use and costs. The antihypertensive effects of amlodipine and valsartan are well established. This study evaluated the efficacy and safety of amlodipine/valsartan 5/160 mg SPC for the treatment of hypertension in predominantly Chinese patients not adequately controlled on valsartan 160 mg alone.
In this multicentre study (24 centres), adults with stage 1 or 2 hypertension not adequately controlled with valsartan monotherapy were randomised to receive double-blind amlodipine/valsartan 5/160 mg SPC or valsartan 160 mg once daily for 8 weeks.
The least-square mean change (standard error) from baseline to endpoint in mean sitting diastolic blood pressure (MSDBP) at trough, the primary efficacy variable, was -10.3 (0.39) mm Hg with amlodipine/valsartan and -6.6 (0.40) mm Hg with valsartan (difference: -3.7 [0.54] mm Hg, p<0.0001). The corresponding results for mean sitting systolic blood pressure (MSSBP) were -14.9 (0.61) mm Hg and -7.0 (0.61) mm Hg, respectively (difference: -7.9 [0.84] mm Hg, p<0.0001). A significantly greater proportion of patients achieved overall BP control (MSSBP/MSDBP<140/90 mm Hg) with combination therapy (61.3%) versus monotherapy (39.3%; p<0.0001). Both treatments were well tolerated.
Amlodipine/valsartan 5/160 mg SPC is a safe and effective therapy for lowering BP in predominantly Chinese adults with stage 1 or 2 hypertension not adequately controlled with valsartan 160 mg monotherapy.
大多数高血压患者需要使用≥2 种降压治疗药物才能达到血压(BP)目标。单片复方制剂(SPC)可能会提高治疗的便利性和依从性,减少医疗资源的使用和成本。氨氯地平和缬沙坦的降压作用已得到充分证实。本研究评估了氨氯地平/缬沙坦 5/160mg SPC 治疗主要为中国人的高血压患者的疗效和安全性,这些患者单独使用缬沙坦 160mg 治疗后血压仍未得到充分控制。
在这项多中心研究(24 个中心)中,接受缬沙坦单药治疗但血压仍未得到充分控制的 1 期或 2 期高血压成年患者被随机分为接受双盲氨氯地平/缬沙坦 5/160mg SPC 或缬沙坦 160mg 每日一次治疗 8 周。
从基线到终点时,最低平方均值变化(标准误差)在谷值时的平均坐位舒张压(MSDBP)是氨氯地平/缬沙坦组-10.3(0.39)mmHg,缬沙坦组-6.6(0.40)mmHg(差异:-3.7[0.54]mmHg,p<0.0001)。相应的平均坐位收缩压(MSSBP)结果分别为-14.9(0.61)mmHg 和-7.0(0.61)mmHg(差异:-7.9[0.84]mmHg,p<0.0001)。与单药治疗相比,联合治疗(61.3%)有更多的患者达到了总体血压控制(MSSBP/MSDBP<140/90mmHg)(差异:39.3%;p<0.0001)。两种治疗方法均具有良好的耐受性。
氨氯地平/缬沙坦 5/160mg SPC 是一种安全有效的治疗方法,可降低主要为中国人的 1 期或 2 期高血压患者的血压,这些患者单独使用缬沙坦 160mg 治疗后血压仍未得到充分控制。