Why the study?
It was unknown whether a fixed combination of losartan and amlodipine is superior to losartan monotherapy regarding hemodynamic parameters and arterial stiffness in systemic arterial hypertension.
Does a fixed combination of losartan/amlodipine improve hemodynamic and arterial stiffness parameters in patients with systemic hypertension compared to losartan monotherapy?
Does a fixed combination of losartan/amlodipine improve hemodynamic and arterial stiffness parameters in patients with systemic hypertension compared to losartan monotherapy?
A fixed-dose combination of losartan and amlodipine improves arterial stiffness and hemodynamic parameters more effectively than losartan monotherapy in patients with grade 1 and 2 hypertension.
Losartan/amlodipine fixed combination improved PWV and hemodynamics versus losartan in small trial; leaves open larger outcome studies before practice change.
Purpose/Background/Objectives Hypertension (HAS) represents 9.4 million deaths from all the cases of cardiovascular disease worldwide [1]. The pulse wave velocity (PWV) and some hemodynamic parameters have been associated with this outcome [2,3]. Losartan, as well as amlodipine, have shown benefits on hemodynamic parameters [4,5] however, it is unknown if losartan/amlodipine combination is better than losartan as a monotherapy. We evaluated losartan/amlodipine effect in a fixed combination versus losartan on hemodynamic and arterial stiffness parameters in patients with systemic arterial hypertension. Design and Methods We conducted a randomized, double-blind study in 28 hypertensive patients according to AHA criteria 2017 [6]. 14 patients received losartan 100 mg per day and 14 losartan/amlodipine 100/5 mg per day, for 8 weeks. Hemodynamic parameters and arterial stiffness measurement were performed with a Mobil-O-Graph ® [7]. Results The combination of losartan/amlodipine improved hemodynamic and arterial stiffness parameters compared with losartan, reducing peripheral vascular resistance (RVP) (0.10 ± 0.08 vs 0.05 ± 0.08), PWV (0.52 ± 0.45 vs 0.33 ± 0.359), daytime PWV (7.24 ± 0.90 vs 7.61 ± 1.03), nocturnal PWV (6.86 ± 0.96 vs 7.27 ± 1.17) and diastolic blood pressure (DBP) (11.21 ± 6.15 vs 5.92 ± 7.65).d) Conclusion We did not find differences between single or combined medication in terms of BP reduction. However, arterial stiffness parameters were better in the combined therapy.
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Jiménez et al. (2019) studied this question.
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