Article
Differential Combination Treatment Strategy in Hypertensive Patients with concomitant Metabolic Diseases
Differenzierte Kombinationsstrategien in der Hypertonietherapie bei metabolisch gestörten Patienten
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Published: | August 10, 2005 |
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Aim: To investigate efficacy and safety of a Verapamil/Trandolapril based therapy in hypertensive patients with concomitant metabolic disorders.
Methods: Open label study in 248 patients with moderate or severe hypertension and diabetes and/or dyslipidemia and/or body mass index greater 27kg/m2, which was conducted May 2001 to October 2003 at 13 sites in Germany. All patients were initially treated with a once daily combination of 180mg Verapamil SR and 2mg Trandolapril. Further antihypertensive drugs such as Moxonidine, Hydrochlorothiazide or Verapamil were systematic added and/or dose was increased if blood pressure goals less than 140/90mmHg were not achieved.
Results: The median follow-up period was 182 days. Efficacy data were available for 235 patients with a mean systolic and diastolic blood pressure of 167.1±15.3 or 97.1±8.9mmHg and a mean resting heart rate of 82.9±13.7 beats/min at baseline. Blood pressure goals were achieved by 82.6% of patients. 104 patients were treated with Verapamil/Trandolapril once daily alone and 131 patients with an intensified combination therapy with the following BP normalization rates: plus HCT 80.8 %, Moxonidine 76.7 % and Verapamil ret. 100 %. Mean systolic or diastolic blood pressure and heart rate reductions were 34.8±18.4mmHg, 15.3±9.6mmHg and 10.2±13.5 beats/min and were confirmed by ambulatory blood pressure measurement. Lipid parameters, fasting glucose, HbA1c and microalbuminuria improved significantly. 5 patients reported adverse events that were minor such as cough, constipation or headache and disappeared after withdrawal of study medication. No adverse effects on laboratory or ECG safety parameters were seen.
Conclusion: A Verapamil/Trandolapril based therapy is clinically effective and safe in hypertensive patients with concomitant metabolic diseases and improves markedly the cardiovascular risk profile.