Journal ArticleDOI
Comparison of efficacy and side effects of combination therapy of angiotensin-converting enzyme inhibitor (benazepril) with calcium antagonist (either nifedipine or amlodipine) versus high-dose calcium antagonist monotherapy for systemic hypertension.
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TLDR
Combined therapy with a calcium antagonist and an ACE inhibitor provides blood pressure control equal to that of high-dose calcium antagonist monotherapy but with significantly fewer dose-dependent adverse experiences such as vasodilatory edema.Abstract:
The present 2 multicenter studies were designed to evaluate whether patients with essential hypertension derived equal benefits from use of combination therapy with a calcium antagonist and angiotensin-converting enzyme (ACE) inhibitor as from doubling the dose of the calcium antagonist. After a 2-week washout and a 2-week single-blind placebo run-in period, a total of 1,390 patients were treated with either nifedipine 30 mg (study 1) or amlodipine 5 mg (study 2) once daily for 4 weeks. The 1,079 patients whose diastolic blood pressure remained between 95 and 115 mm Hg were randomized to 8 weeks of double-blind therapy with amlodipine 5 mg/benazepril 10 mg, amlodipine 5 mg/ benazepril 20 mg, nifedipine 30 mg or nifedipine 60 mg (study 1), and amlodipine 5 mg/benazepril 10 mg, amlodipine 5 mg/benazepril 20 mg, amlodipine 5 mg or amlodipine 10 mg (study 2). Both doses of the calcium antagonist/ACE inhibitor combination therapy lowered diastolic pressure as much as the high dose and significantly better than the lower dose of calcium antagonist monotherapy (with either nifedipine or amlodipine). However, 15% of patients in the nifedipine high-dose monotherapy group and 24% in the amlodipine high-dose monotherapy group presented with some form of edema. In contrast, the incidence of edema was similar for patients treated with both combination therapy and low-dose calcium antagonists. Thus, combination therapy with a calcium antagonist and an ACE inhibitor provides blood pressure control equal to that of high-dose calcium antagonist monotherapy but with significantly fewer dose-dependent adverse experiences such as vasodilatory edema. Inc.read more
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Journal ArticleDOI
Thiazolidinedione Use, Fluid Retention, and Congestive Heart Failure A Consensus Statement From the American Heart Association and American Diabetes Association
Richard W. Nesto,David S.H. Bell,Robert O. Bonow,Vivian Fonseca,Scott M. Grundy,Edward S. Horton,Martin Le Winter,Daniel Porte,Clay F. Semenkovich,Sidney C. Smith,Lawrence H. Young,Richard Kahn +11 more
TL;DR: Because people with diabetes are at increased risk for CVD and many have preexisting heart disease, the edema that sometimes accompanies the use of a TZD can be cause for concern, as it may be a harbinger or sign of congestive heart failure (CHF).
Journal ArticleDOI
Thiazolidinedione use, fluid retention, and congestive heart failure: a consensus statement from the American Heart Association and American Diabetes Association.
Richard W. Nesto,David S.H. Bell,Robert O. Bonow,Vivian Fonseca,Scott M. Grundy,Edward S. Horton,Martin Le Winter,Daniel Porte,Clay F. Semenkovich,Sidney C. Smith,Lawrence H. Young,Richard Kahn +11 more
TL;DR: Beneficial effects of TZDs on glycemia and cardiovascular risk factors have made them attractive agents in patients with type 2 diabetes who are at high risk for CVD, there is a growing recognition, however, that edema can occur in patients treated with either drug.
Journal ArticleDOI
Management of High Blood Pressure in African Americans: Consensus Statement of the Hypertension in African Americans Working Group of the International Society on Hypertension in Blacks
Janice G. Douglas,George L. Bakris,Murray Epstein,Keith C. Ferdinand,Carlos M. Ferrario,John M. Flack,Kenneth Jamerson,Wendell E. Jones,Julian Haywood,Randall Maxey,Elizabeth Ofili,Elijah Saunders,Ernesto L. Schiffrin,Domenic A. Sica,James R. Sowers,Donald G. Vidt +15 more
TL;DR: The purpose of this consensus statement is to offer primary care providers a practical, evidence-based clinical tool for achieving blood pressure goals in African American patients.
Journal ArticleDOI
Outcomes in Hypertensive Black and Nonblack Patients Treated With Chlorthalidone, Amlodipine, and Lisinopril
Jackson T. Wright,J. Kay Dunn,Jeffrey A. Cutler,Barry R. Davis,William C. Cushman,Charles E. Ford,L. Julian Haywood,Frans H. H. Leenen,Karen L. Margolis,Vasilios Papademetriou,Jeffrey L. Probstfield,Paul K. Whelton,Gabriel B. Habib +12 more
TL;DR: While the improved outcomes with chlorthalidone were more pronounced for some outcomes in blacks than in nonblacks, thiazide-type diuretics remain the drugs of choice for initial therapy of hypertension in both black and nonblack hypertensive patients.
Journal ArticleDOI
Outcomes in Hypertensive Black and Nonblack Patients Treated With Chlorthalidone, Amlodipine, and Lisinopril
TL;DR: In blacks and nonblack subgroups, rates were not lower in the amlodipine or lisinopril groups than in the chlorthalidone group for either the primary CHD or any other prespecified clinical outcome, and diuretic-based treatment resulted in the lowest risk of heart failure.
References
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Journal Article
The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure
Journal ArticleDOI
Single-Drug Therapy for Hypertension in Men -- A Comparison of Six Antihypertensive Agents with Placebo
Barry J. Materson,Barry J. Materson,Domenic J. Reda,William C. Cushman,Barry M. Massie,Edward D. Freis,Mahendr S. Kochar,Robert J. Hamburger,Carol L. Fye,Raj Lakshman,John S. Gottdiener,Eli A. Ramirez,William G. Henderson +12 more
TL;DR: Among men, race and age have an important effect on the response to single-drug therapy for hypertension, and these factors should be considered in the initial choice of a drug.
Journal ArticleDOI
Treatment of Mild Hypertension Study: Final Results
James D. Neaton,Richard H. Grimm,Ronald J. Prineas,Jeremiah Stamler,Gregory A Grandits,Patricia J. Elmer,Jeffrey A. Cutler,John M. Flack,J A Schoenberger,Robert McDonald +9 more
TL;DR: Findings support the recommendations of the new fifth Joint National Committee report regarding treatment choices for people with stage 1 ("mild") hypertension, as an initial regimen was more effective in preventing cardiovascular and other clinical events than was nutritional-hygienic treatment alone.
Journal ArticleDOI
The treatment of mild hypertension study.
TL;DR: The Treatment of Mild Hypertension Study (TOMHS) represents a worthy contribution to the evaluation of therapeutic interventions on outcomes in patients with mild hypertension and the overall benefit of antihypertensive agents plus lifestyle modification compared with lifestyle modification alone.
Journal ArticleDOI
Combined Enalapril and Felodipine Extended Release (ER) for Systemic Hypertension
TL;DR: In this trial, the combination of enalapril and felodipine ER effectively lowered BP and was generally well tolerated with an excellent safety profile when used in the treatment of hypertension.
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