The blood pressure goals set for the treatment of hypertensive patients have been lowered in recent guidelines. To reduce blood pressure levels sufficiently, combination therapies are often needed, but there is little evidence about which combination should be chosen. The present study was carried out to compare the effects of combination therapies, including the angiotensin receptor blocker olmesartan and either a calcium channel blocker (CCB) or a thiazide diuretic, in elderly patients with hypertension. A total of 65 patients aged 65-85 years, with blood pressures of 140/90 mm Hg or higher for those taking antihypertensive medication or 160/100 mm Hg or higher for those not on medication, were randomly assigned to either the group treated with olmesartan plus a dihydropyridine CCB or the group treated with olmesartan plus a thiazide diuretic; 58 patients completed the treatment for 6 months. Systolic and diastolic blood pressures (SBP and DBP) were reduced during the treatment period in both the groups. The reductions in SBP at 1 and 6 months were significantly (Po0.05) greater in the CCB combination group than in the diuretic group (À29 vs. À18 mm Hg, respectively, at 1 month; À32 vs. À23 mm Hg, respectively, at 6 months). Despite greater reduction in SBP in the CCB group, the serum creatinine level and the estimated glomerular filtration rate (eGFR) remained unchanged, whereas in the diuretic group, creatinine was elevated (+0.06 mg per 100 ml, Po0.05) and eGFR was reduced (À4.5 ml min À1 per 1.73 m 2 ). In addition, high-density lipoprotein cholesterol levels were reduced in the diuretic group (À5.0 mg per 100 ml, Po0.01). These results suggest that olmesartan plus a CCB is the preferable combination therapy in comparison with olmesartan plus a thiazide diuretic for elderly patients with hypertension.

SUMMARYA controlled, double-blind study of effects of dl-alpha-tocopheryl nicotinate (vitamin E-nicotinate: EN) for relief of symptoms was perf ormed in 94 patients with hypertension and cerebral arteriosclerosis. Eighty-nine cases (44 cases treated with EN and 45 with inactive placebo) had completed this study, and remaining 5 cases were dropped out. Six capsules of EN (600mg) in the treated group and 6 capsules of inactive placebo in the placebo group were given daily for 4 weeks in all cases, and for 6 weeks in 43 cases. The following results were obtained.1) The general improvement rating was significantly greater in EN group than that in placebo group (p<0.005).2) For 5 items of subjective symptoms, the improvement rating of EN was relatively higher than that of placebo. The result of statistical analysis of them was as follows; numbness of limbs (p=0.032), dizziness (p=0.054), stiff neck (p<0.10), heavy feeling of head (p<0.10), and insomnia (p=0.025).3) The general improvement rating increased consistently as related to the time intervals following the treatment in EN group as follows; 73.7%

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