Amlodipine pius telmisartan or amiloride for hypertension in moderate and high-risk patients: A 24-week observation

Abstract

Objective: The aim of the present study was to evaluate the short-term effect of amlodipine-based antihypertensive combination regimens on reduction of blood pressure and adverse effect in hypertensive patients with moderate or high risk of cardiovascular event. Methods: In this randomized, blinded trial, 106 hypertensive patients met the inclusion criteria and were enrolled. Patients were randomly assigned to A group (amlodipine 2.5 mg plus telmisartan 80 mg group) or B group (amlodipine 2.5 mg plus 1 tablet of amiloride group); amlodipine 2.5 mg could be added if blood pressure beyond control at 4 weeks. Follow up was 24 weeks. Primary efficacy parameter was reduction of blood pressure at 24 weeks. Physical and laboratory characteristics and side effects were recorded. Results: Baseline systolic blood pressure was 160.5±16.5 mm Hg and diastolic blood pressure was 98.7±9.7 mm Hg. After 2 weeks treatment, mean systolic blood pressure in group A and B was (151.5±14.8)mm Hg and (144.4±13.9)mmHg, respectively (P<0.05). Mean diastolic blood pressure in group A and B was reduced to (91.7±9.6)mm Hg and (90.1±9.4)mm Hg, respectively (P>0.05). Blood pressure control rate was 47.2% and 58.1% in group A and B (P<0.05). After 24 weeks of therapy, there were no significant differences on reduction of blood pressures (SBPs 24.3±15.8 vs 26.8±13.4, P>0.05) (DBPs 15.2±9.2 vs15.7±9.4, P>0.05) or blood pressure control rates (67.9% of vs 71.7%, P>0.05) in two groups. Compared with A and B groups, both of them reported equivalent of adverse effects (7.6% of amiloride vs 9.4% of telmisartan, P>0.05). Conclusion: Amlodipine-based antihypertensive combination strategies achieved satisfactory blood pressure control in hypertensive patients with moderate or high cardiovascular risk. Yet, more predominant efficacy on the reduction of blood pressure and blood pressure control rates shows in the combination of amlodipine and amiloride at 2-week follow-up. Adverse effects and organ benefits beyond reducing blood pressure warrant longer clinical observation.