gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

Fixed-dose combination (ramipril-felodipine ER) in the first line therapy of essential hypertension ("IndComb"-Study)

Fixkombination - Ramipril plus Felodipin ER - Indikation in der first-line Therapie der essentiellen Hypertonie ("Indkomb"-Studie)

Meeting Abstract (Hypertonie 2003)

  • presenting/speaker J. Scholze - Charité CCM (Berlin, D)
  • M. Bida - Charité CCM (Berlin, D)
  • D. Juncken - Charité CCM (Berlin, D)
  • A. Ritz - Charité CCM (Berlin, D)
  • Y. Dörffel - Charité CCM (Berlin, D)
  • A. Hansen - Charité CCM (Berlin, D)

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochP11

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hoch2003/03hoch111.shtml

Veröffentlicht: 11. November 2004

© 2004 Scholze et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

The therapy of hypertension is characterized by an initial use of monotherapies, which are combined in the later course if necessary. Despite the availability of a large number of effective drugs, less than a quarter of hypertensive patients are normotensive worldwide. This poor situation leads to the question of a therapy-paradigm change, which was first official published in a statement at the JNC VII (2003).

To prove the hypothesis that fixed-dose combinations are not only more effective on long term but also safe in the first-line use, we conducted a randomised prospective multicenter pilot study, in which the fixed-dose combination of ramipril and felodipine ER was compared with the ramipril and felodipine monotherapy, in 150 patients with hypertension grad II-III. To identify symptomatic and asymptomatic hypotensive episodes we combined the 24-h-ambulatory-blood pressure monitoring (ABPM) on the first day of drug intake with a careful registration of all adverse events.

The acute effects on BP are listed in table 1 [Tab. 1]. There were no differences between the groups with regard to the number and intensity of the adverse effects. After 4 weeks of treatment the fixed-dose combination ram + fel lowered the systolic and diastolic blood pressure (office BP, daily profile of self-BP-measurement and ABPM) significantly more than the monotherapies. Furthermore the fixed-dose combination showed a trend for better tolerability.

The results support the primary use of the fixed-dose combination ramipril and felodipine in the arterial hypertension to improve the antihypertensive efficacy and tolerability, which should be re-evaluated in a further large double-blind study.