Combination therapy with amlodipine and benazepril increased arterial distensibility (0.71 vs 0.28 and 0.39 % mL/mm Hg) more than high-dose amlodipine or benazepril monotherapies.
RCT (n=106)
Open-label
Does combination therapy with amlodipine and benazepril improve arterial distensibility and reduce left ventricular mass more than high-dose monotherapy in patients with mild-to-moderate hypertension?
Combination therapy with an ACE inhibitor and CCB is more effective than high-dose monotherapy in improving arterial compliance and reducing left ventricular mass in hypertensive patients.
Absolute Event Rate: 0.71% vs 0.28%
p-value: p=0.008
BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers (CCBs) increase arterial compliance and decrease left ventricular mass in hypertensive patients. This study examined whether combined therapy has greater arterial and cardiac effects than doubled doses of the individual drugs. METHODS: This prospective, randomized, open-label study enrolled 106 patients aged >/=18 years with mild-to-moderate hypertension. Patients were randomized to 5 mg of amlodipine or 20 mg of benazepril for 2 weeks; then, depending on randomization assignment, they were force-titrated to 10 mg of amlodipine or 40 mg of benazepril monotherapy, or to combination amlodipine (5 mg) and benazepril (20 mg) treatment for 22 weeks. Arterial distensibility was assessed using the DynaPulse ambulatory system, and left ventricular mass was assessed by echocardiography. RESULTS: Combination therapy (0.71% +/- 0.51% mL/mm Hg) increased arterial distensibility more than amlodipine (0.28% +/- 0.69% mL/mm Hg; P =.008) or benazepril (0.39% +/- 0.62% mL/mm Hg; P =.03) monotherapies. Left ventricular mass decreased more with combination treatment (65 +/- 56 g) than with amlodipine (28 +/- 4 g; P <.02); the difference from benazepril (42 +/- 50 g) was not significant. CONCLUSIONS: Combined ACE inhibitor and CCB treatment was more efficacious than high doses of the individual agents in increasing arterial compliance and reducing left ventricular mass. These findings indicate that appropriately selected combinations of antihypertensive drugs might have enhanced cardioprotective effects.
Joel M. Neutel (Tue,) conducted a rct in Mild-to-moderate hypertension (n=106). Combination amlodipine and benazepril vs. Amlodipine 10 mg or benazepril 40 mg monotherapy was evaluated on Arterial distensibility (p=0.008). Combination therapy with amlodipine and benazepril increased arterial distensibility (0.71 vs 0.28 and 0.39 % mL/mm Hg) more than high-dose amlodipine or benazepril monotherapies.