Weber Michael A, White William B, Sica Domenic, Bakris George L, Cao Charlie, Roberts Andrew, Kupfer Stuart
aDownstate Medical Center, State University of New York, New York, New York bUniversity of Connecticut School of Medicine, Farmington, Connecticut cVirginia Commonwealth University Health System, Richmond, Virginia dUniversity of Chicago Medicine, Chicago eTakeda Global Development Center Americas fTakeda Pharmaceuticals International, Deerfield, Illinois.
Blood Press Monit. 2014 Apr;19(2):90-7. doi: 10.1097/MBP.0000000000000027.
The aim of the study was to measure the effects on blood pressure (BP) of the angiotensin receptor blocker azilsartan medoxomil, in 40 and 80 mg doses, combined with 5 mg of the calcium channel blocker amlodipine and to compare these effects with placebo plus amlodipine 5 mg.
This was a randomized, controlled, double-blind study of 6 weeks' duration in 566 patients with stage 2 hypertension. The primary endpoint was 24-h systolic BP by ambulatory monitoring.
The mean age of the participants was 58 years; men and women were equally represented, and baseline 24-h BP (153-154/93 mmHg) and clinic BP (165-166/94-95 mmHg) were similar across the three treatment groups. After 6 weeks, 24-h BP decreased by 25/15 mmHg in both the azilsartan medoxomil/amlodipine 40/5 and 80/5 mg groups. These reductions were each greater than the 14/8 mmHg decrease with placebo plus amlodipine 5 mg (P≤0.001 for both comparisons). All treatments were well tolerated, and adverse events did not increase with the azilsartan medoxomil doses. Edema or fluid retention was less common in both combination groups (2.6 and 2.7%) than with placebo plus amlodipine (7.6%).
Coadministration of azilsartan medoxomil with amlodipine was well tolerated and led to meaningful additional BP reductions compared with placebo plus amlodipine.
本研究旨在测量40毫克和80毫克剂量的血管紧张素受体阻滞剂阿齐沙坦美洛昔酯联合5毫克钙通道阻滞剂氨氯地平对血压(BP)的影响,并将这些影响与安慰剂加5毫克氨氯地平进行比较。
这是一项针对566例2级高血压患者的为期6周的随机、对照、双盲研究。主要终点是通过动态监测24小时收缩压。
参与者的平均年龄为58岁;男女比例均衡,三个治疗组的基线24小时血压(153 - 154/93 mmHg)和诊室血压(165 - 166/94 - 95 mmHg)相似。6周后,阿齐沙坦美洛昔酯/氨氯地平40/5毫克组和80/5毫克组的24小时血压均下降了25/15 mmHg。这些降幅均大于安慰剂加5毫克氨氯地平组的14/8 mmHg降幅(两项比较P均≤0.001)。所有治疗耐受性良好,不良事件并未随阿齐沙坦美洛昔酯剂量增加而增多。两个联合治疗组中水肿或液体潴留的发生率(分别为2.6%和2.7%)均低于安慰剂加氨氯地平组(7.6%)。
与安慰剂加氨氯地平相比,阿齐沙坦美洛昔酯与氨氯地平联合用药耐受性良好,并能显著进一步降低血压。