Sugimoto Danny H, Chrysant Steven G, Melino Michael, Lee James, Fernandez Victor, Heyrman Reinilde
Cedar-Crosse Research Center and Rush Medical College, Chicago, IL, USA.
Integr Blood Press Control. 2013 Jul 12;6:89-99. doi: 10.2147/IBPC.S45450. Print 2013.
Elevated systolic blood pressure is more difficult to control than elevated diastolic blood pressure. The objective of this prespecified analysis of the Triple Therapy with Olmesartan Medoxomil, Amlodipine, and Hydrochlorothiazide in Hypertensive Patients Study (TRINITY) was to compare the efficacy of olmesartan medoxomil (OM) 40 mg, amlodipine besylate (AML) 10 mg, and hydrochlorothiazide (HCTZ) 25 mg triple-combination treatment with the component dual-combination treatments in reducing elevated seated systolic blood pressure (SeSBP).
The 12-week TRINITY study randomized participants to either one of the three component dual-combination treatments (OM 40 mg/AML 10 mg, OM 40 mg/HCTZ 25 mg, or AML 10 mg/HCTZ 25 mg) or the triple-combination treatment. The primary outcome of this analysis was the categorical distribution of SeSBP reductions at week 12 from baseline with OM 40 mg/AML 10 mg/HCTZ 25 mg versus the dual-combination treatments.
SeSBP reductions >50 mmHg were seen in 24.4% of participants receiving triple-combination treatment versus 8.1%-15.8% receiving dual-combination treatment. More participants receiving triple-combination treatment achieved the SeSBP target of <140 mmHg (73.6% versus 51.3%-58.8%; P < 0.001) and the seated blood pressure target of <140/90 mmHg (69.9% versus 41.1%-53.4%; P < 0.001). Prevalence and severity of adverse events were similar in all treatment groups.
Treatment with OM 40 mg/AML 10 mg/HCTZ 25 mg was well tolerated and more effective in reducing SeSBP than the dual-combination treatments.
收缩压升高比舒张压升高更难控制。奥美沙坦酯、氨氯地平和氢氯噻嗪三联疗法治疗高血压患者研究（TRINITY）的这项预先指定分析的目的是比较40毫克奥美沙坦酯（OM）、10毫克苯磺酸氨氯地平（AML）和25毫克氢氯噻嗪（HCTZ）三联组合治疗与各组分双联组合治疗在降低坐位收缩压升高（SeSBP）方面的疗效。
为期12周的TRINITY研究将参与者随机分配至三种组分双联组合治疗（40毫克OM/10毫克AML、40毫克OM/25毫克HCTZ或10毫克AML/25毫克HCTZ）之一或三联组合治疗。该分析的主要结局是在第12周时，40毫克OM/10毫克AML/25毫克HCTZ三联组合治疗与双联组合治疗相比，SeSBP从基线降低的分类分布情况。
接受三联组合治疗的参与者中有24.4%的人SeSBP降低>50 mmHg，而接受双联组合治疗的这一比例为8.1%-15.8%。更多接受三联组合治疗的参与者实现了SeSBP目标<140 mmHg（73.6%对51.3%-58.8%；P<0.001）以及坐位血压目标<140/90 mmHg（69.9%对41.1%-53.4%；P<0.001）。所有治疗组中不良事件的发生率和严重程度相似。
40毫克OM/10毫克AML/25毫克HCTZ治疗耐受性良好，在降低SeSBP方面比双联组合治疗更有效。
