Key result
Amlodipine and Lisinopril, each combined with bendroflumethiazide, similarly reduced systolic blood pressure by 43 mmHg and 40 mmHg respectively after 4 weeks, with no significant difference between groups.
Why the study?
Guidelines suggest initial combination therapy for grade 2 or higher hypertension, but the specific combination choice remains at clinician discretion amid concerns that ACEIs are less effective in black hypertensive patients.
Does Amlodipine/Bendroflumethiazide compared to Lisinopril/Bendroflumethiazide reduce blood pressure in hypertensive Tanzanians with moderate to severe hypertension?
RCT (n=239)
Open-label
Computer-generated random numbers
Yes
Does Amlodipine/Bendroflumethiazide compared to Lisinopril/Bendroflumethiazide reduce blood pressure in hypertensive Tanzanians with moderate to severe hypertension?
Mean Difference: 3 (95% CI 1–6)
Absolute Event Rate: 43% vs 40%
p-value: p=0.093
Amlodipine and lisinopril, each combined with bendroflumethiazide, are similarly effective in significantly reducing blood pressure in native Tanzanians with moderate to severe hypertension.
Recent guidelines have suggested combination therapy as initial treatment in hypertensive patients with ≥ grade 2 hypertension, aiming to achieve target blood pressure (BP) goal faster and more effectively. Both calcium channel blockers (CCBs) and angiotensin converting enzyme inhibitors (ACEIs) are in the list of first-line antihypertensives, however the choice of the combination therapy is left to the discretion of the clinician, and there are concerns that ACEIs are less effective in BP reduction among black hypertensives.
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Pilly et al. (2021) conducted an RCT in Moderate to severe hypertension (≥ grade 2) (n=239). Amlodipine and Bendroflumethiazide vs. Lisinopril and Bendroflumethiazide (5/5 mg) was evaluated on Mean change in office systolic blood pressure from baseline to 4 weeks (MD 3, 95% CI 1-6, p=0.093). Amlodipine and Lisinopril, each combined with bendroflumethiazide, similarly reduced systolic blood pressure by 43 mmHg and 40 mmHg respectively after 4 weeks, with no significant difference between groups.
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