A Comparative Study of the Management of Stage 2 hypertension by Combined therapy with Losartan, Amlodipine and Hydrochlorothiazide

AUTHORS

Reza Jafarzadeh Esfehani 1 , Azadeh Mahmoodi Gharai 2 , Ali Jafarzadeh Esfehani 3 , Afsaneh Rezaie Kalat 4 , Faezeh Abbasi 1 , Majid Jalalyazdi 5 , *

1 1Education Development Center, Sabzevar University of Medical Sciences, Sabzevar, Iran

2 Mashhad University of medical science, Mashhad, Iran

3 2Mashhad University of medical science, Mashhad, Iran

4 Education Development Center, Sabzevar University of Medical Sciences, Sabzevar, Iran

5 Cardiology Department, Sabzevar University of Medical Sciences, Sabzevar, Iran

How to Cite: Jafarzadeh Esfehani R , Mahmoodi Gharai A , Jafarzadeh Esfehani A , Rezaie Kalat A , Abbasi F , et al. A Comparative Study of the Management of Stage 2 hypertension by Combined therapy with Losartan, Amlodipine and Hydrochlorothiazide, Int Cardio Res J. 2017 ; 6(3):e12801.

ARTICLE INFORMATION

International Cardiovascular Research Journal: 6 (3); e12801
Published Online: October 20, 2011
Article Type: Research Article
Received: May 09, 2017
Accepted: October 20, 2011

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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.

Keywords

Angiotensin Receptor Blocker Calcium Channel Blocker Hypertension

© 0, Shiraz University of Medical Sciences.

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