Author/Authors :
Jafarzadeh Esfehani، Reza نويسنده Sabzevar University of Medical Sciences , , Mahmoodi Gharai، Azadeh نويسنده Mashhad University of medical science, Mashhad, IR Iran , , Jafarzadeh Esfehani، Ali نويسنده Sabzevar University of Medical Sciences , , Rezaie Kalat، Afsaneh نويسنده Education Development Center, Sabzevar University of Medical Sciences, Sabzevar, IR Iran , , Abbasi، Faezeh نويسنده Education Development Center, Sabzevar University of Medical Sciences, Sabzevar, IR Iran , , Jalalyazdi، Majid نويسنده Cardiologist, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran ,
Abstract :
Background: The most effective and accurate treatment of hypertensive patients reduces cardiovascular events and improves the quality of life.
Objective: This study compared the efficacy and safety of combined (combination therapy) with an angiotensin-receptor blocker (ARB) a calcium-channel blocker (CCB) (Losartan / Amloidipine 50/10mg) vs maximal combination doses of ARB with hydrochlorothiazide (Losartan /HCTZ 100/25 mg) and maximal combination doses of CCB with HCTZ (Amlodipine /HCTZ 10/25 mg) in the management of stage 2 hypertension.
Methods: This randomized clinical trial (RTC) comprised 478 hypertensive patients with mean age 50.5±5.21 years, and took place between January 2010 and December 2011 in Vasei Hospital clinic in Sabzevar. Antihypertensive drugs were washed out after 5 days of discontinuation of drugs and the patients with mean blood pressure in sitting position ? 160 and < 200 mmHg in systole and ? 100 and < 110 mmHg in diastole were randomized into three groups: Losartan / Amlodipine 50/10 mg (n =164) , Losartan / HCTZ 100/25 mg (n =155) and Amlodipine / HCTZ 10/25 mg (n =159). The end point was reaching the blood pressure below 140/90 within 56 days of treatment in each group.
Results: There was a significant difference in systolic blood pressure reductions between treatment groups (P < 0.001) and also there was a significant difference between groups in reducing diastolic blood pressure (P < 0.01). The highest systolic and diastolic blood pressure reduction respectively was found in Amlodipine/losartane and losartane/HTCZ group. The ANCOVA analysis revealed that only treatment regimen had a significant effect (P=0.01) and other factor including Age, Gender, Diabetes Mellitus, Smoking and High serum cholesterol didn’t have significant effect on blood pressure reduction.
Conclusion: ARB/CCB combination therapy reduced blood pressure more effectively than the maximal doses of ARB or CCB with HCTZ in stage 2 hypertensive patients within this period of study.
