Key result
Combination therapy with 20 mg/d quinapril plus 5 mg/d amlodipine significantly reduced systolic blood pressure compared to 40 mg/d quinapril monotherapy (9.9 vs 4.3 mm Hg; P<.001).
Why the study?
Does quinapril 20 mg/d plus amlodipine 5 mg/d improve blood pressure reduction compared to quinapril 40 mg/d in patients with diabetes and hypertension not at goal on quinapril 20 mg/d?
RCT (n=329)
Does quinapril 20 mg/d plus amlodipine 5 mg/d improve blood pressure reduction compared to quinapril 40 mg/d in patients with diabetes and hypertension not at goal on quinapril 20 mg/d?
In diabetic hypertensive patients not at goal on quinapril 20 mg/d, adding amlodipine 5 mg/d is more effective at lowering blood pressure than doubling the quinapril dose to 40 mg/d.
Answers are grounded in this paper and cite their sources.
Supports adding amlodipine over quinapril uptitration in diabetic hypertension not at goal; confirms combination superiority in RCT evidence.
This randomized, comparative, parallel-group trial investigated strategies of blood pressure (BP)-lowering in patients with diabetes and hypertension. Patients not reaching goal BP (<130/80 mm Hg) after 4-week open-label treatment with quinapril 20 mg/d (n=374) received 40 mg/d quinapril (n=167) or 20 mg/d quinapril plus amlodipine besylate (5 mg/d; n=162) for 6 weeks. Patients receiving combination therapy vs monotherapy had significantly greater reductions in mean +/- SE sitting systolic BP (9.9+/-1.0 mm Hg vs 4.3+/-1.1 mm Hg; P<.001) and diastolic BP (6.5+/-0.6 mm Hg vs 2.7+/-0.6 mm Hg; P<.001). No significant differences between groups were observed in percentage of patients achieving goal BP (10.1% with combination therapy vs 8.2% with monotherapy). A clinically neutral effect was observed on high-sensitivity C-reactive protein in both groups. Treatments were well tolerated; fewer than 3% of patients in any group discontinued due to treatment-emergent or treatment-related adverse events. In diabetic hypertensive patients, 20 mg/d quinapril plus 5 mg/d amlodipine besylate was a more effective BP-lowering strategy than monotherapy with 40 mg/d quinapril.
No takes yet. Share an insight, caveat, or question.
Tobe et al. (2007) conducted an RCT in Hypertension in Diabetes (n=329). Quinapril plus amlodipine besylate vs. Quinapril 40 mg/d was evaluated on Reduction in mean sitting systolic BP (p=<.001). Combination therapy with 20 mg/d quinapril plus 5 mg/d amlodipine significantly reduced systolic blood pressure compared to 40 mg/d quinapril monotherapy (9.9 vs 4.3 mm Hg; P<.001).
Synapse has enriched 10 related papers. Consider them for comparative context: