Combination therapy with lercanidipine and enalapril reduced central blood pressure augmentation in hypertensive patients with metabolic syndrome

Ghiadoni, Lorenzo; Bruno, Rosa Maria; Cartoni, G.; Stea, Francesco; Magagna, Armando; Virdis, Agostino; Grassi, Davide; Ferri, Claudio; Taddei, Stefano

doi:10.1016/j.vph.2015.06.004

Cited by 11 publications

(9 citation statements)

References 29 publications

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“…Arterial stiffness and augmentation index were studied in hypertensive patients with metabolic syndrome in a study that compared the effect of combination therapy with an ACE inhibitor plus CCB or thiazide diuretic on these parameters. The combination of lercanidipine/enalapril caused a similar pulse wave velocity reduction as compared to hydrochlorothiazide, but a greater reduction in augmentation index indicating a potential additive role on central BP augmentation for the lercanidipine/enalapril combination, which may result in effective protection from target organ damage, such as left ventricular hypertrophy and peripheral vascular damage 56. Noninvasive measurements of wall-to-lumen ratio and other morphological parameters of retinal arterioles using scanning laser Doppler flowmetry were evaluated in a study of lercanidipine/enalapril or thiazide diuretic.…”

Section: Metabolic Actions Of the Fixed Combinationmentioning

confidence: 90%

Combination therapy with lercanidipine and enalapril in the management of the hypertensive patient: an update of the evidence

Antza

Stabouli

Kotsis

2016

VHRM

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Hypertension is an important risk factor for premature death as it increases the probability of stroke, myocardial infarction, and heart failure. Antihypertensive drugs can decrease cardiovascular (CV) morbidity and mortality. The majority of hypertensive patients need more than one antihypertensive agent to attain blood pressure (BP) targets. Monotherapy can effectively reduce BP only in 20%–40% of patients. Multiple mechanisms including increased peripheral vascular resistance, increased cardiac work, and hypervolemia are involved in the pathogenesis of hypertension. Targeting multiple pathways may more potently reduce BP. Increasing the dose of a single agent in many cases does not provide the expected BP-lowering effect because the underlying mechanism of the BP increase is either different or already corrected with the lower dose. Moreover, drugs acting on different pathways may have synergistic effects and thus better control hypertension. It is well known that diuretics enhance the actions of renin–angiotensin aldosterone system and activate it as a feedback to the reduced circulated blood volume. The addition of a renin–angiotensin aldosterone system blocker to a diuretic may more effectively reduce BP because the system is upregulated. Reducing the maximal dose of an agent may also reduce possible side effects if they are dose dependent. The increased prevalence of peripheral edema with higher doses of calcium channel blockers (CCBs) is reduced when renin–angiotensin aldosterone system blockers are added to CCBs through vein dilation. The effectiveness of the combination of enalapril with lercanidipine in reducing BP, the safety profile, and the use of the combination of angiotensin-converting enzyme inhibitors with CCBs in clinical trials with excellent CV hard end point outcomes make this combination a promising therapy in the treatment of hypertension.

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Section: Metabolic Actions Of the Fixed Combinationmentioning

confidence: 90%

Combination therapy with lercanidipine and enalapril in the management of the hypertensive patient: an update of the evidence

Antza

Stabouli

Kotsis

2016

VHRM

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“…Podobne obserwacje dotyczyły także innych badań odnoszących się do stosowania lerkanidipiny i enalaprilu w podobnej grupie chorych lub u pacjentów w wieku podeszłym [23,24]. Co więcej, istniejące dowody kliniczne nie tylko potwierdziły skuteczność hipotensyjną połącze nia, ale także wskazywały dodatkowe korzyści związane z redukcją ryzyka sercowonaczyniowego [25][26][27][28][29].…”

Section: Połączenie Enalaprilu I Lerkanidipiny -Dowody Kliniczneunclassified

Inhibitor konwertazy angiotensyny z antagonistą wapnia trzeciej generacji — nowy lek złożony w terapii hipotensyjnej. Stanowisko ekspertów

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Widecka

Tykarski³

et al. 2017

Arterial Hypertension

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“… 7 , 36 – 38 Three studies compared the efficacy of lercanidipine 10 mg/enalapril 20 mg to enalapril 20 mg/hydrochlorothiazide 12.5 mg combination in different populations of hypertensive patients. 7 , 36 , 37 The first study, 36 carried out in diabetic hypertensive patients with a body mass index >30 kg/m 2 uncontrolled by enalapril treatment, has shown a greater efficacy in terms of clinic blood pressure reduction of lercanidipine 10 mg when compared to hydrochlorothiazide 12.5 mg as add-on to the ACE inhibitor treatment based on enalapril 20 mg. Indeed, following a 20-week follow-up, the percentage of responders, defined as diastolic blood pressure decrease ≥10 mmHg or as achievement of blood pressure values ≤130/85 mmHg, was greater in the group under the former than under the latter combination treatment.…”

Section: Comparative Studies With Other Drug Combinationsmentioning

confidence: 99%

“…Similarly, a recent study carried out in hypertensive patients with central obesity and metabolic syndrome has shown greater effects of the lercanidipine 10–20 mg/enalapril 20 mg combination as compared to lercanidipine 10–20 mg/hydrochlorothiazide 12.5–25 mg on augmentation index, ie, a sensitive marker of wave reflection and arterial stiffness derived from the blood pressure waveform. 37 …”

Section: Comparative Studies With Other Drug Combinationsmentioning

confidence: 99%

Lercanidipine/enalapril combination in the management of obesity-related hypertension

Grassi

2016

IBPC

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Obesity-related hypertension represents a condition frequently observed in current clinical practice characterized by a complex pathophysiological background and a very high cardiovascular risk profile, particularly in severely obese individuals. This explains, on the one hand, the difficulty in reducing elevated blood pressure values in this pathological state and, on the other, the need to achieve this goal in a relatively short-time period to prevent the occurrence of fatal and nonfatal cardiovascular events. Both nonpharmacological and pharmacological measures are available in the therapeutic approach for this condition. Among the pharmacological interventions, a combination of two antihypertensive drugs represents the most common recommended strategy aimed at achieving blood pressure control. This paper, after briefly examining the main pathophysiological features of obesity-related hypertension, will review the importance in the treatment of this condition of the drug combination based on a calcium channel blocker and an angiotensin-converting enzyme inhibitor, with specific focus on lercanidipine/enalapril. Following an analysis of the main pharmacological properties of the combination, the results of the studies based on this pharmacological approach in obesity-related hypertension will be critically discussed. The efficacy, safety, and tolerability profile of the lercanidine/enalapril drug combination as well as its potential limitations will also be examined.

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Combination therapy with lercanidipine and enalapril reduced central blood pressure augmentation in hypertensive patients with metabolic syndrome

Cited by 11 publications

References 29 publications

Combination therapy with lercanidipine and enalapril in the management of the hypertensive patient: an update of the evidence

Combination therapy with lercanidipine and enalapril in the management of the hypertensive patient: an update of the evidence

Inhibitor konwertazy angiotensyny z antagonistą wapnia trzeciej generacji — nowy lek złożony w terapii hipotensyjnej. Stanowisko ekspertów

Lercanidipine/enalapril combination in the management of obesity-related hypertension

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