PS 14-53 COMPARISON OF TWO COMBINED ANTIHYPERTENSIVE THERAPY IN HYPERTENSIVE PATIENTS WITH METABOLIC SYNDROME

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Abstract

Objective:

High blood pressure is considered one of the key features of metabolic syndrome (MS). It is a very prominent feature of the metabolic syndrome, present in up to 85% of patients. Aim of the study was to compare the efficacy and tolerability of perindopril 4 mg + amlodipine 5 mg combination (P + A) versus lisinopril 5 mg + amlodipin 5 mg (L + A) combination in patients with MS.

Design and Method:

We investigated 112 hypertensive patients with metabolic syndrome with mild-to-moderate arterial hypertension not adequately controlled by a monotherapy with ACE inhibitors or calcium channel blockers or ARB entered this work, randomized, parallel-group study. After a two week placebo run-in, all patients with sitting diastolic blood pressure (DBP) > 95 mmHg and/or sitting systolic (BP > 160 mmHg were randomized to receive either P+A (56 patients) or L + A (56 patients) once daily for 12 weeks. The presence of metabolic syndrome was diagnosed by Harmonized Metabolic Syndrome definition. Main outcome measure was sitting DBP and SBP values at the end of active treatment. The response rate was defined as the proportion of patients with either a final sitting DBP < 90 mmHg or decreased by at least 10 mmHg or a sitting SBP < 150 mmHg or decreased by at least 20 mmHg from baseline.

Results:

The DBP and SBP values obtained with P + A were, respectively, 1.5 and 2.3 mmHg lower than those obtained with L + A (both p < 0.005). The response rate in the P + A group (91.2%) was better than that observed in the L + A group (87.6%, p < 0.05). The incidence of adverse events was similar with the 2 treatment groups (15.3% vs. 16.8 %, p < 0.02).

Conclusions:

These data suggest a higher antihypertensive efficacy of the fixed combination P 4 mg + A 5 mg as compared with L 5 mg + A 5 mg.

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