Key result
Amlodipine-candesartan therapy reduces DBP ~8 mmHg more than amlodipine alone in uncontrolled hypertension.
Why the study?
Effective antihypertensive therapy is essential for optimal blood pressure control, prompting evaluation of amlodipine combined with candesartan cilexetil versus amlodipine monotherapy in uncontrolled essential hypertension.
Does amlodipine and candesartan cilexetil combination therapy reduce blood pressure in patients with essential hypertension uncontrolled by amlodipine monotherapy?
RCT (n=180)
Double-blind
1:1
Yes
Does amlodipine and candesartan cilexetil combination therapy reduce blood pressure in patients with essential hypertension uncontrolled by amlodipine monotherapy?
Effect estimate: Difference: 7.84 mmHg (95% CI 5.44-10.24)
Absolute Event Rate: -9.92% vs -2.08%
p-value: p=< 0.0001
The combination of amlodipine and candesartan cilexetil significantly reduces both systolic and diastolic blood pressure compared to amlodipine monotherapy in patients with uncontrolled essential hypertension, without increasing adverse events.
Supports adding candesartan to amlodipine for better control in uncontrolled hypertension; confirms additive BP reduction in this RCT.
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.
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Soh et al. (2024) conducted an RCT in Essential hypertension (n=180). Amlodipine and candesartan cilexetil vs. Amlodipine 5 mg monotherapy was evaluated on Change in diastolic blood pressure (DBP) at week 8 from baseline (Difference: 7.84 mmHg, 95% CI 5.44-10.24, p=< 0.0001). Amlodipine and candesartan cilexetil combination therapy significantly reduced diastolic blood pressure by an additional 7.84 mmHg compared to amlodipine monotherapy in patients with uncontrolled essential hypertension.
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