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

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Amlodipine versus candesartan cilexetil in hypertensives: office and home measurement data

Amlodipin versus candesartancilexetil bei Hypertonikern: Daten fuer Praxisblutdruck und Selbstmessung

Meeting Abstract (Hypertonie 2003)

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  • presenting/speaker P. Trenkwalder - Klinikum Starnberg, Pfizer (Starnberg, Karlsruhe, D)
  • E. Regourd - Klinikum Starnberg, Pfizer (Starnberg, Karlsruhe, D)
  • B. Kluth-Pepper - Klinikum Starnberg, Pfizer (Starnberg, Karlsruhe, D)
  • N. Sauerbrey-Wullkopf - Klinikum Starnberg, Pfizer (Starnberg, Karlsruhe, D)

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochP18

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2003/03hoch118.shtml

Published: November 11, 2004

© 2004 Trenkwalder et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective

To evaluate antihypertensive efficacy, tolerability and metabolic effects of the calcium channel blocker amlodipine (AML) versus the AT1 receptor antagonist candesartan cilexetil (CAN) in patients with essential hypertension.

Design and Methods

Multicenter, multicountry, double-blind, parallel group study of 12-weeks active treatment followed by 4 drug free days. Patients were randomised with office SBP 140-199 mmHg and office DBP 95-114 mmHg. The initial once daily dose of AML 5mg and CAN 8mg was doubled at week 6 if office DBP was not controlled. Sitting office BP was measured every 2 weeks with an automatic device (OMRON 705CP). Home blood pressure was measured 5 times daily during the study. Blood samples were drawn before and after 12 weeks of treatment for various lab tests.

Results

A total of 326 patients were randomised (mean age 54 years, 55% male). 40.1% of AML patients were titrated to AML 10mg and 42.7% of CAN patients were titrated to CAN 16mg. After 12 weeks active therapy mean office BP was reduced by 24.4mmHg/14.9mmHg with AML and by 22.3/14.8mmHg with CAN. AML patients reached in 46.9% SBP/DBP control (i.e.<140/90mmHg) and CAN patients reached in 44.4% SBP/DBP control. Office heart rate was lowered by both drugs (-3.8 beats/min by AML and -5.9 beats/min by CAN). There was an increase in office BP during the 4-day drug free period of 9.1/5.0mmHg with AML and 8.3/4.6mmHg with CAN. Mean reductions from baseline in home BP for AML and CAN were 10.7/7.4mmHg and 8.6/4.9mmHg, respectively. Plasma fibrinogen was unaffected by CAN (+1.4mg/dl) but decreased with AML (-21.1mg/dl). A total of 47.9% of patients on AML and 39.1% on CAN reported adverse events.

Conclusions

Both monotherapies were very effective in lowering office BP after 12 weeks of treatment. There was a trend for better home BP reduction with AML. The overall frequency of adverse events was comparable, the decrease in fibrinogen with AML needs further confirmation.