Comparison of antihypertensive effects of an angiotensin-converting enzyme inhibitor, a calcium antagonist and a diuretic in patients with hypertension not controlled by angiotensin receptor blocker monotherapy

Stergiou, George S.; Makris, Thomas; Papavasiliou, Maria; Efstathiou, Stamatis P.; Manolis, Athanasios

doi:10.1097/01.hjh.0000163159.22116.ab

Cited by 51 publications

(29 citation statements)

References 37 publications

(65 reference statements)

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“…In hypertensive patients whose BP could not be controlled by the maximum dose of an Rationale, design and implementation of COLM study T Ogihara et al ARB, adding a diuretic or CCB was reported to enhance the antihypertensive effect. 17,18 The ultimate goal of combination therapy is to reduce cardiovascular outcomes in addition to reducing BP. Only two large-scale randomized clinical trials have investigated which combination of antihypertensive agents is more effective in preventing cardiovascular diseases in hypertensive patients.…”

Section: Discussionmentioning

confidence: 99%

Rationale, study design and implementation of the COLM study: the combination of OLMesartan and calcium channel blocker or diuretic in high-risk elderly hypertensive patients

et al. 2009

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on behalf of the COLM study investigatorsThe COLM study is an investigator-initiated trial comparing the combination therapy using an angiotensin II receptor blocker (ARB), olmesartan, and a calcium channel blocker (CCB) with that using an ARB and a diuretic in high-risk elderly hypertensive patients. Here we describe the rationale and study design. Olmesartan was administered concomitantly with a long-acting dihydropyridine CCB (ARB/CCB group) or with a low-dose diuretic (ARB/diuretic group) to elderly hypertensive patients with a history of or risk factors for cardiovascular disease. Cardiovascular morbidity and mortality as a primary end point were compared between the two groups, with the target blood pressure (BP) being o140 mm Hg for systolic BP and o90 mm Hg for diastolic BP. Safety and tolerability will also be investigated. A total of more than 4000 patients were recruited and will be followed up for at least 3 years.

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Section: Discussionmentioning

confidence: 99%

Rationale, study design and implementation of the COLM study: the combination of OLMesartan and calcium channel blocker or diuretic in high-risk elderly hypertensive patients

et al. 2009

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“…Обе комбинации продемонстрировали высокую эффективность, особенно в отдельных клинических группах паци-ентов. Необходимо отметить, что некоторые ком-бинации более эффективны, чем другие, как пока-зали Stergiou et al [28]. Так, комбинация препара-тов, действующих на одни и те же патогенетические механизмы, может быть менее эффективна, чем сочетание препаратов с разными механизмами дей-ствия.…”

Section: следующий шаг: фиксированная комбинацияunclassified

Treatment of essential hypertension with calcium channel blockers: what is the place of lercanidipine?

Burnier

Pruijm²,

Wuerzner³

2009

Expert Opinion on Drug Metabolism & Toxicology

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“…Combining classes of agents with complementary mechanisms of action, such as CCBs and RAS blockers, provides greater BP-lowering efficacy than monotherapy, [68][69][70][71][72][73][74][75] with a comparable and potentially improved adverse-event profile. 76 However, few trials have been designed to test the effect of specific antihypertensive combinations on cardiovascular or renal end points.…”

Section: Dual Calcium Channel/ras Blockadementioning

confidence: 99%

Targeting mechanisms of hypertensive vascular disease with dual calcium channel and renin–angiotensin system blockade

Weir

2007

J Hum Hypertens

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Patients with hypertension, particularly those with diabetes mellitus, are at heightened risk for cardiovascular and renal disease. Accumulated evidence indicates that the majority of hypertensive patients at high risk will require more than one antihypertensive agent to reach their blood pressure (BP) target. A reasonable strategy is to use agents with complementary mechanisms of action to enhance BP-lowering efficacy and prevent target organ damage. In experimental models, the combination of a calcium channel blocker (CCB) with an agent that blocks the renin-angiotensin system (RAS), an angiotensinconverting enzyme (ACE) inhibitor or angiotensin receptor blocker, improves measures of endothelial function, inflammation, ventricular remodelling and renal function to a greater degree than these classes given as monotherapy. In clinical trials, calcium channel/RAS blockade combination therapy has been shown to provide greater BP reductions and improve renal function in patients with diabetic and nondiabetic renal disease earlier and to a greater extent than monotherapy. In addition, dual calcium channel/RAS blockade increases arterial compliance, arterial distensibility and flow-mediated vasodilation. Expanding upon extensive research on the benefits of calcium channel blockade and RAS blockade for the prevention of vascular events and preclinical and clinical trial evidence suggests added effects of combination therapy by targeting the underlying mechanisms of hypertensive vascular disease.

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Comparison of antihypertensive effects of an angiotensin-converting enzyme inhibitor, a calcium antagonist and a diuretic in patients with hypertension not controlled by angiotensin receptor blocker monotherapy

Cited by 51 publications

References 37 publications

Rationale, study design and implementation of the COLM study: the combination of OLMesartan and calcium channel blocker or diuretic in high-risk elderly hypertensive patients

Rationale, study design and implementation of the COLM study: the combination of OLMesartan and calcium channel blocker or diuretic in high-risk elderly hypertensive patients

Treatment of essential hypertension with calcium channel blockers: what is the place of lercanidipine?

Targeting mechanisms of hypertensive vascular disease with dual calcium channel and renin–angiotensin system blockade

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