LOSARTAN/AMLODIPINE IN ARTERIAL STIFFNESS SHOWS DOMINANT EFFICACY IN REDUCING 24 HOURS BRACHIAL AND CENTRAL BP COMPARED WITH LOSARTAN/HYDROCHLOROTHIAZID OR IN NORMAL ARTERY

Abstract

Objective: The aim of this research was to compare the efficacy between 20 weeks treatments of losartan/amlodipine(L/A) versus losartan/hydrochlorothiazide(L/H) combination therapy in reducing 24 hours brachial and central blood pressure (BP) according to the severity of baseline arterial stiffness measured by 24 hours pulse wave velocity (PWV). Design and method: The K-central research was a prospective, randomized, double-blind, multicenter trial including 231 hypertensive patients (mean age = 59.2±12.2 years). Patients take losartan 50 mg monotherapy for 4 weeks, followed by additional amlodipine 5 mg (L/A) or hydrochlorothiazide 12.5 mg (L/H) for 20 weeks after randomization. The patients who did not achieve the BP goal after 4 weeks’ randomization receive an increased dose of losartan 100 mg for the L/A group and increased doses of losartan 100 mg and hydrochlorothiazide 25 mg for L/H group. The 24 hours brachial BP, central BP, and PWV were measured using an oscillometric device (Mobil-O-Graph 24-hour PWA monitor, I.E.M. Gmbh, Stolberg, Germany) at baseline and after 20 weeks’ treatment. Results: The main results of this research are presented in the table and figure. Conclusions: We concluded that L/A combination therapy in subjects with advanced arterial stiffness shows dominant efficacy in reducing 24 hours mean brachial and central BP compared with in subjects without arterial stiffness or with L/H combination therapy.