Why the study?
Does the combination of candesartan and lisinopril reduce blood pressure more effectively than monotherapy in elderly patients with systolic hypertension?
Population
n=23 elderly patients with systolic hypertension (including 8 patients with microalbuminuria)
Comparison
Candesartan 16 mg + lisinopril 20 mg combination… vs Placebo, candesartan 16 mg, candesartan 32 mg…
Design
RCT, crossover study, double-blind
Follow-up
one month per treatment period
Authors
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Small incremental BP reduction does not support ACEI+ARB combination; challenges assumptions of meaningful additive effects in systolic hypertension.
Does the combination of candesartan and lisinopril reduce blood pressure more effectively than monotherapy in elderly patients with systolic hypertension?
Combining an ACE inhibitor and an ARB provides only a small incremental reduction in blood pressure compared to monotherapy, lending no support to their combined use for hypertension.
Morgan et al. (2004) studied this question.
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