Comparative Study on Monotherapy with Sustained-Release Diltiazem 300 mg and Enalapril 20 mg in Mild to Moderate Arterial Hypertension

Fermé, I; Djian, Jacques; Tcherdakoff, P

doi:10.1097/00005344-199000161-00009

Cited by 13 publications

(7 citation statements)

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“… ' 13 In this study the combination of both treatments, albeit at the lower individual doses, produced a clinically significant fall in blood pressure in patients resistant to monotherapy. These results are similar to those reported previously 14. …”

supporting

confidence: 93%

A Multicentre Study to Compare the Therapeutic Efficacy of Sustained‐release Diltiazem and Enalapril in the Treatment of Patients With Mild to Moderate Hypertension

Weir

Lee²,

Clegg³

et al. 1994

Int J Clinical Practice

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SUMMARY A 14‐week study was conducted in order to compare the efficacy and tolerability of a twice‐daily sustained‐release diltiazem preparation (120 or 180 mg) and once‐daily enalapril (10 or 20 mg). Patients not achieving an adequate response after 6 weeks on monotherapy were given a combination therapy of twice‐daily diltiazem 120 mg and once‐daily enalapril 10 mg. Of the 147 patients admitted to the study, 70 received diltiazem and 77 received enalapril; 17 patients subsequently received combination therapy. Blood pressure reductions in patients completing 12 weeks of therapy were (sitting values): diltiazem 120 mg, 10.2/15.2 mmHg; diltiazem 180 mg, 19.1/14.7 mmHg; enalapril 10 mg, 25.7/17.5 mmHg; enalapril 20 mg, 19.6/14.0 mmHg; and combination therapy, 24.6/15.1 mmHg. No significant differences in the incidence level of individual symptoms were seen between the two groups: 34 (49%) in the diltiazem, 37 (48%) in the enalapril group; and, between weeks 6 and 12, 9 (53%) patients taking combination therapy. Two patients withdrew from the enalapril group and 8 from the diltiazem group. No unexpected side‐effects were seen during the study and no deaths occurred in any treatment group. Twice‐daily sustained‐release diltiazem 120 or 180 mg was shown to be an effective antihypertensive agent and equal in efficacy and patient acceptability to once‐daily enalapril 10 or 20 mg. Combination therapy effectively lowered blood pressure in patients in whom monotherapy was ineffective.

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supporting

confidence: 93%

A Multicentre Study to Compare the Therapeutic Efficacy of Sustained‐release Diltiazem and Enalapril in the Treatment of Patients With Mild to Moderate Hypertension

Weir

Lee²,

Clegg³

et al. 1994

Int J Clinical Practice

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“…In two studies of moderate/severe hypertension amlodipine was used in combination with either enalapril (Jensen et al, 1990) or captopril (Maclean et al, 1988). Jensen et al (1990) Ferme et al (1990) compared diltiazem (300 mg), enalapril (20 mg) and enalapril and diltiazem in combination. The reductions in supine blood pressure achieved with the three treatments were 22/20 mm Hg, 20/11 mm Hg and 23/19 mm Hg respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Both drugs were similarly well tolerated. Ferme et al (1990) compared diltiazem (300 mg), enalapril (20 mg) and enalapril and diltiazem in combination. The reductions in supine blood pressure achieved with the three treatments were 22/20 mm Hg, 20/11 mm Hg and 23/19 mm Hg respectively.…”

Section: Discussionmentioning

confidence: 99%

A comparison of amlodipine with enalapril in the treatment of moderate/severe hypertension.

Fowler

Webster

Lyons

et al. 1993

Brit J Clinical Pharma

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1. The safety and efficacy of amlodipine vs enalapril as monotherapy was evaluated in patients with moderate/severe hypertension (supine DBP 105‐125 mm Hg, SBP 140‐220 mm Hg). 2. After 2 weeks placebo treatment 31 patients were randomised by the technique of minimisation in an observer‐blind study to receive once daily treatment with either amlodipine (15 patients) 5‐10 mg, or enalapril (16 patients) 5‐20 mg for 8 weeks. The study design concluded with 2 weeks placebo treatment. In addition to clinic measurements, home blood pressure monitoring (Copal UA‐251) was performed during the study. 3. Clinic supine systolic blood pressure was reduced from 177 to 152 mm Hg (amlodipine) and 183 to 169 mm Hg (enalapril) (95% CI for the intergroup difference ‐ 22.1, 0.3, P = 0.06) after 8 weeks treatment. 4. Clinic supine diastolic blood pressure was reduced from 110 to 93 mm Hg (amlodipine) and 109‐102 mm Hg (enalapril) (95% CI for the intergroup difference ‐ 17.7, ‐2.7, P < 0.01) after 8 weeks treatment. 5. Home blood pressure recordings confirmed these reductions in blood pressure. Although the reduction in blood pressure was greater for the amlodipine treated group, the differences between treatments were not statistically significant. 6. Both drugs were reasonably well tolerated. The adverse events occurring most frequently in the amlodipine group were headache (5), peripheral oedema (3), upper respiratory infection (3) and anxiety (2). The adverse events occurring most frequently in the enalapril treated patients were headache (6), dizziness (3) and upper respiratory infection (2).

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“…We analyzed the baseline characteristics of hypertensive patients enrolled in different clinical trials of aliskiren, amlodipine, bisoprolol, enalapril, hydrochlorothiazide, and losartan ( Abate et al, 1998 ; Agabiti Rosei et al, 2005 ; Brown et al, 2011 ; Corea et al, 1996 ; Cushman et al, 2012 ; Derosa et al, 2014 ; Fagher et al, 1990 ; Fermé et al, 1990 ; Gradman et al, 2005 ; Koh et al, 2004 ; Kwakernaak et al, 2017 ; Lee et al, 2012 ; Lithell et al, 1987 ; Mallion, 2007 ; Martina et al, 1999 ; Narkiewicz, 2007 ; Nedogoda et al, 2013 ; Oparil et al, 1996 ; Oparil et al, 2008 ; Pareek et al, 2016 ; Paterna et al, 2007 ; Pool et al, 2007 ; Porthan et al, 2009 ; Puig et al, 2007 ; Sun et al, 2016 ; Tham et al, 1993 ; Weber et al, 1995 ; Wing et al, 2003 ). Based on these characteristics, we selected suitable mean and SD values for the necessary quantities.…”

Section: Methodsmentioning

confidence: 99%

Mathematical modeling of antihypertensive therapy

et al. 2022

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Hypertension is a multifactorial disease arising from complex pathophysiological pathways. Individual characteristics of patients result in different responses to various classes of antihypertensive medications. Therefore, evaluating the efficacy of therapy based on in silico predictions is an important task. This study is a continuation of research on the modular agent-based model of the cardiovascular and renal systems (presented in the previously published article). In the current work, we included in the model equations simulating the response to antihypertensive therapies with different mechanisms of action. For this, we used the pharmacodynamic effects of the angiotensin II receptor blocker losartan, the calcium channel blocker amlodipine, the angiotensin-converting enzyme inhibitor enalapril, the direct renin inhibitor aliskiren, the thiazide diuretic hydrochlorothiazide, and the β-blocker bisoprolol. We fitted therapy parameters based on known clinical trials for all considered medications, and then tested the model’s ability to show reasonable dynamics (expected by clinical observations) after treatment with individual drugs and their dual combinations in a group of virtual patients with hypertension. The extended model paves the way for the next step in personalized medicine that is adapting the model parameters to a real patient and predicting his response to antihypertensive therapy. The model is implemented in the BioUML software and is available at https://gitlab.sirius-web.org/virtual-patient/antihypertensive-treatment-modeling.

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Comparative Study on Monotherapy with Sustained-Release Diltiazem 300 mg and Enalapril 20 mg in Mild to Moderate Arterial Hypertension

Cited by 13 publications

References 0 publications

A Multicentre Study to Compare the Therapeutic Efficacy of Sustained‐release Diltiazem and Enalapril in the Treatment of Patients With Mild to Moderate Hypertension

A Multicentre Study to Compare the Therapeutic Efficacy of Sustained‐release Diltiazem and Enalapril in the Treatment of Patients With Mild to Moderate Hypertension

A comparison of amlodipine with enalapril in the treatment of moderate/severe hypertension.

Mathematical modeling of antihypertensive therapy

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