Key result
Fixed-dose olmesartan/amlodipine was superior to perindopril/amlodipine in reducing central systolic blood pressure (difference -3.51 mm Hg; 95% CI -6.66 to -0.36; superiority margin 0 mm Hg).
Why the study?
Does olmesartan/amlodipine reduce central systolic blood pressure more than perindopril/amlodipine in hypertensive patients with type 2 diabetes?
RCT
Does olmesartan/amlodipine reduce central systolic blood pressure more than perindopril/amlodipine in hypertensive patients with type 2 diabetes?
Mean Difference: -3.51 (95% CI -6.66–-0.36)
Absolute Event Rate: -13.72% vs -10.21%
In hypertensive patients with type 2 diabetes, fixed-dose olmesartan/amlodipine was superior to perindopril/amlodipine in reducing central systolic blood pressure.
OLM/AML may be preferred over PER/AML for central BP control in diabetic hypertension; extends SEVITENSION RCT to this subgroup.
This post hoc analysis from the Sevikar Compared to the Combination of Perindopril Plus Amlodipine on Central Arterial Blood Pressure in Patients With Moderate-to-Severe Hypertension (SEVITENSION) study assessed the efficacy and tolerability of olmesartan (OLM) and amlodipine (AML) in reducing central systolic blood pressure (CSBP) compared with perindopril (PER) plus AML in hypertensive patients with type 2 diabetes. Patients were randomized to OLM/AML 40/10 mg or PER/AML 8/10 mg for 24 weeks. The primary efficacy endpoint was the absolute change in CSBP from baseline to week 24, which was greater with OLM/AML (-13.72±1.14 mm Hg) compared with PER/AML (-10.21±1.11 mm Hg). The between-group difference was -3.51±1.60 mm Hg (95% confidence interval, -6.66 to -0.36 mm Hg) and was within the noninferiority margin (2 mm Hg) as well as the superiority margin (0 mm Hg). In addition, OLM/AML was associated with a higher proportion of patients achieving blood pressure normalization. In hypertensive patients with diabetes, the fixed-dose combination of OLM/AML was superior to PER/AML in reducing CSBP, as well as other secondary endpoints.
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Luís M. Ruilope (2015) conducted an RCT in Hypertension with type 2 diabetes. Olmesartan/Amlodipine vs. Perindopril/Amlodipine 8/10 mg was evaluated on absolute change in central systolic blood pressure (CSBP) from baseline to week 24 (MD -3.51 mm Hg, 95% CI -6.66 to -0.36). Fixed-dose olmesartan/amlodipine was superior to perindopril/amlodipine in reducing central systolic blood pressure (difference -3.51 mm Hg; 95% CI -6.66 to -0.36; superiority margin 0 mm Hg).
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