Objective: To compare the clinical efficacy of low- dose controlled- release(CR) nifedipine(20 mg/day) plus candesartan(8 mg/day) combination therapy with that of up- titrated candesartan(12 mg/day) monotherapy. Desig...Objective: To compare the clinical efficacy of low- dose controlled- release(CR) nifedipine(20 mg/day) plus candesartan(8 mg/day) combination therapy with that of up- titrated candesartan(12 mg/day) monotherapy. Design: Randomized, double- blind study. Setting: Outpatient study. Patients and participants: Patients with essential hypertension, who did not achieve their target blood pressure with baseline treatment of candesartan 8 mg/day for 8 weeks. Main outcome measures: Blood pressure, pulse pressure, urinary microalbumin excretion. Results: Blood pressure was significantly reduced in both groups(P< 0.05), but the reduction was significantly greater in the combination therapy group(12.1± 1.4/ 8.7± 0.9 mmHg) than in the up- titrated monotherapy group(4.1± 1.4/4.6± 0.9 mmHg)(P< 0.0001). The reduction in pulse pressure was significantly greater in the combination therapy group(3.3± 1.2 mmHg) than in the up- titrated monotherapy group(0.7± 1.2mmHg)(P=0.0031). Urinary microalbumin excretion decreased significantly in the combination therapy group(from 61.9 to 40.5 mg/g creatinine; P< 0.05), but not in the up- titrated monotherapy group. Conclusions: These findings suggest that the lowdose combination therapy of nifedipine CR and candesartan is superior to the up- titrated monotherapy of candesartan in terms of blood pressure control and renal protection in patients with essential hypertension.展开更多
文摘Objective: To compare the clinical efficacy of low- dose controlled- release(CR) nifedipine(20 mg/day) plus candesartan(8 mg/day) combination therapy with that of up- titrated candesartan(12 mg/day) monotherapy. Design: Randomized, double- blind study. Setting: Outpatient study. Patients and participants: Patients with essential hypertension, who did not achieve their target blood pressure with baseline treatment of candesartan 8 mg/day for 8 weeks. Main outcome measures: Blood pressure, pulse pressure, urinary microalbumin excretion. Results: Blood pressure was significantly reduced in both groups(P< 0.05), but the reduction was significantly greater in the combination therapy group(12.1± 1.4/ 8.7± 0.9 mmHg) than in the up- titrated monotherapy group(4.1± 1.4/4.6± 0.9 mmHg)(P< 0.0001). The reduction in pulse pressure was significantly greater in the combination therapy group(3.3± 1.2 mmHg) than in the up- titrated monotherapy group(0.7± 1.2mmHg)(P=0.0031). Urinary microalbumin excretion decreased significantly in the combination therapy group(from 61.9 to 40.5 mg/g creatinine; P< 0.05), but not in the up- titrated monotherapy group. Conclusions: These findings suggest that the lowdose combination therapy of nifedipine CR and candesartan is superior to the up- titrated monotherapy of candesartan in terms of blood pressure control and renal protection in patients with essential hypertension.
