Why the study?
Does adding nifedipine CR or amlodipine to ARB monotherapy reduce blood pressure and left ventricular hypertrophy in uncontrolled hypertensive patients?
Does adding nifedipine CR or amlodipine to ARB monotherapy reduce blood pressure and left ventricular hypertrophy in uncontrolled hypertensive patients?
Adding a long-acting calcium channel blocker to ARB monotherapy provides additional blood pressure reduction and antihypertrophic effects in patients with uncontrolled essential hypertension.
Supports adding long-acting CCB to ARB monotherapy in uncontrolled hypertension; extends evidence for LV mass regression in RCT.
The aim of the present study was to examine the antihypertensive and antihypertrophic effects of combined treatment with a long-acting calcium antagonist on top of an angiotensin II receptor blocker (ARB) in uncontrolled hypertensive patients. Patients with essential hypertension and a blood pressure > 140/90 mmHg on ARB monotherapy (losartan 50 mg/day or candesartan 8 mg/day) were randomly assigned to a nifedipine controlled release (CR) group (n = 15) or amlodipine group (n = 11). A significant additional antihypertensive effect was noted from 1 month with nifedipine and 2 months with amlodipine. The average daily dose was 25 mg for nifedipine and 5 mg for amlodipine. The cardiothoracic ratio was significantly reduced in both groups after 3 months. Left ventricular wall thickness and left ventricular mass index also decreased. Metabolic parameters, hepatic function, and renal function did not change significantly. Additional treatment with a long-acting calcium antagonist achieved further blood pressure reduction as well as an antihypertrophic effect in the uncontrolled patients with prior ARB monotherapy.
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Kodama et al. (2009) studied this question.
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