Efficacy and Tolerability of Candesartan Cilexetil and Amlodipine in Patients with Poorly Controlled Essential Hypertension

Kazuaki Nishio,Youichi Kobayashi,Takeshi Kondo

doi:10.4236/ijcm.2011.22012

Abstract

Current treatment guidelines for hypertension in both Europe and the USA stress the importance of aggressive blood pressure control. When monotherapy is not enough to reach treatment targets, there is a need for combination regi-mens that have both high efficacy and good tolerability. The aim of this study is to evaluate the efficacy and toler-ability of the combination therapy candesartan and amlodipine in patients with hypertension not satisfactorily controlled by monotherapy. Patients with uncomplicated essential hypertension not satisfactorily controlled by monotherapy, which is candesartan 8 mg or amlodipine 5 mg, were eligible. Candesartan 8 mg and amlodipine 5 mg were given for 12 weeks. 13 patients who received candesartan 8 mg previoursly were assigned to the candesartan group and 8 patients who received amlodipine 5 mg previoursly were assigned to the amlodipine group. Sitting systolic blood pressure (SBP) at baseline was 151.9 ± 11.6 mmHg in the candesartan group, and 154.6 ± 7.6 mmHg in the amlodipine group. Sitting diastolic blood pressure (DBP) was 93.2 ± 13.1 in the candesartan group, and 80.4 ± 14.7 in the amlodipine group. DBP in the amlodipine group was lower than that in the cadesartan group (P = 0.036). After the combination therapy, SBP was significantly reduced in the two groups. DBP showed significant reduction in the amlodipine group. The rate of achieving blood pressure goals was 4% at baseline and significantly increased to 58% after the combination therapy. These results showed that candesartan 8 mg/amlodipine 5 mg are effective lowering blood pressure after 12 weeks in patients not adequately controlled by monotherapy.

Highlights

Angiotensin II type I (AT1) receptor antagonists are a widely used class of antihypertensive agents
These results showed that candesartan 8 mg/amlodipine 5 mg are effective lowering blood pressure after 12 weeks in patients not adequately controlled by monotherapy
The primary objective was to evaluate the effects of the combination therapy of candesartan 8 mg and amlodipine 5 mg on sitting BP for 12 weeks. 13 patients who received candesartan 8 mg previoursly were assigned to the candesartan group and 8 patients who received amlodipine 5 mg previoursly were assigned to the amlodipine group

Summary

Introduction

Angiotensin II type I (AT1) receptor antagonists are a widely used class of antihypertensive agents. [1] Previous studies have shown candesartan cilexetil to be efficacious and well tolerated in patients with mild-tomoderate essential hypertension [2,3]. There is evidence that it may confer target organ protection beyond that attributable to the reduction of blood pressure [4,5,6]. When monotherapy is not enough to reach treatment targets, there is a need for combination regimens that have both high efficacy and good tolerability. There is evidence that some 40% - 60% of patients with hyper- tension will need such combination treatment, largely depending on the amount of BP reduction needed to reach target BP [11,12,13]

Objectives

Methods

Conclusion