Combined therapy with irbesartan and diltiazem significantly improved flow-mediated dilatation from 8.39% at baseline to 10.72% (P<0.05) in patients with essential hypertension.
RCT (n=190)
Does combined therapy of irbesartan and diltiazem improve endothelium-dependent vasodilatation in essential hypertensive patients?
Combined therapy with irbesartan and diltiazem significantly improves endothelial function and reduces left ventricular mass index in patients with essential hypertension.
Absolute Event Rate: 10.72% vs 8.39%
p-value: p=<0.05
Objective: Endothelial function is of prognostic importance for hypertensives. The aim of this study was to investigate the effects of irbesartan combined with diltiazem on the endothelium-dependent vasodilatation in essential hypertensive (EH) patients in China. Methods: A total of 150 Chinese hypertensives aged from 40 to 80 years old were assigned into three groups: irbesartan treated(150 mg/d, n = 46), diltiazem treated (90 mg/d, n = 51), and combined therapy group (irbesartan 150 mg/d+ diltiazem 90 mg/d, n = 53). Forty age and gender-matched normotensives without clinical manifestation of cardiovascular diseases served as controls. High-resolution ultrasonography was used to assess flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation (NMD) in the brachial artery. Left ventricular mass index (LVMI) was calculated. Fibrinogen (Fg) was determined by Clauss and Stago auto analyzer. Blood pressure was measured using mercury sphygmomanometers. Results: FMD and NMD were lower in combined treatment group compared to normotensives before treatment at baseline FMD(8.39 ± 3.04)% vs. (11.21 ± 3.88)%, NMD (13.96 ± 5.71)% vs. (16.78 ± 6.22)%, p < 0.05. FMD was improved significantly after the combined therapy (10.72 ± 3.46)% vs. (8.39 ± 3.04)%, p < 0.05. No significant difference in NMD was found among three hypertensive groups after therapy. Moreover, FMD increased significantly with the prolongation of treatment. After stratification of age, FMD in younger EH patients under 65 years old was markedly increased after treatment within 1 year, whereas FMD in EH patients over 65 years old showed a significant increase after 3-year therapy. In addition, LVMI was reduced in hypertensives after combined therapy (99.1 ± 17.9) g/m2 vs. (90.6 ± 16.2) g/m2, p < 0.01. Logistic analysis showed that age was an important risk factor for FMD. Conclusions: Combined therapy of irbesartan with diltiazem ameliorated endothelial function.
Zhou et al. (Wed,) conducted a rct in Essential hypertension (n=190). Irbesartan and diltiazem vs. Irbesartan alone, diltiazem alone, and baseline was evaluated on Flow-mediated dilatation (FMD) (p=<0.05). Combined therapy with irbesartan and diltiazem significantly improved flow-mediated dilatation from 8.39% at baseline to 10.72% (P<0.05) in patients with essential hypertension.