Soh Moon-Seung, Won Kyung-Heon, Kim Jae-Joong, Lee Sung Yun, Hyon Min Su, Youn Ho-Joong, Rha Seung-Woon, Kim Doo-Il, Ahn Youngkeun, Kim Byung Jin, Choi Dong-Ju, Park Jong-Seon, Kim Dae-Kyung, Park Woo-Jung, Lim Hong-Seok, Tahk Seung-Jea
Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon, 16499, Republic of Korea.
Department of Internal Medicine, Seoul Medical Center, Seoul, Republic of Korea.
Sci Rep. 2024 Oct 3;14(1):22940. doi: 10.1038/s41598-024-74003-5.
Effective antihypertensive therapy is essential for achieving optimal blood pressure (BP) control and reducing cardiovascular events. This double-blind, multicenter, randomized trial aimed to compare the antihypertensive efficacy and safety of a combination of amlodipine (AML) and candesartan cilexetil (CC) versus AML monotherapy in patients with essential hypertension (HTN). After a 4-week run-in period with AML 5 mg, patients whose HTN remained uncontrolled (diastolic BP [DBP]) ≥ 90 mmHg and < 120 mmHg) were randomized to receive either AML + CC or AML alone for 8 weeks. Efficacy was assessed by measuring changes in DBP and systolic BP (SBP). The primary safety measure was the incidence of adverse events (AEs). A total of 174 participants were included in the efficacy analysis. After 8 weeks, DBP decreased by -9.92 ± 0.86 mmHg in the AML + CC arm and - 2.08 ± 0.86 mmHg in the AML arm (p < 0.0001). SBP decreased by -14.27 ± 1.39 mmHg in the AML + CC arm versus - 2.77 ± 1.39 mmHg in the AML arm (p < 0.0001). AEs occurred in 11.24% of the AML + CC group and 5.62% of the AML group (p = 0.1773). AML + CC combination therapy demonstrated superior efficacy with good tolerance, making it a promising option for patients with inadequately controlled hypertension on amlodipine alone.
有效的抗高血压治疗对于实现最佳血压(BP)控制和减少心血管事件至关重要。这项双盲、多中心、随机试验旨在比较氨氯地平(AML)和坎地沙坦酯(CC)联合治疗与AML单药治疗对原发性高血压(HTN)患者的降压疗效和安全性。在使用5毫克AML进行4周的导入期后,高血压仍未得到控制(舒张压[DBP]≥90 mmHg且<120 mmHg)的患者被随机分配接受AML+CC或单独接受AML治疗8周。通过测量DBP和收缩压(SBP)的变化来评估疗效。主要安全指标是不良事件(AE)的发生率。共有174名参与者纳入疗效分析。8周后,AML+CC组的DBP下降了-9.92±0.86 mmHg,AML组下降了-2.08±0.86 mmHg(p<0.0001)。AML+CC组的SBP下降了-14.27±1.39 mmHg,而AML组下降了-2.77±1.39 mmHg(p<0.0001)。AE发生在AML+CC组的11.24%和AML组的5.62%(p=0.1773)。AML+CC联合治疗显示出卓越的疗效和良好的耐受性,使其成为仅使用氨氯地平血压控制不佳患者的一个有前景的选择。