Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2006 Sep;8(9):634-41.
doi: 10.1111/j.1524-6175.2006.05504.x.

Effects of monotherapy and combination therapy on blood pressure control and target organ damage: a randomized prospective intervention study in a large population of hypertensive patients

Michele Adolfo Tedesco  1 , Francesco Natale, Raffaele Calabrò
Affiliations
Clinical Trial

Effects of monotherapy and combination therapy on blood pressure control and target organ damage: a randomized prospective intervention study in a large population of hypertensive patients

Michele Adolfo Tedesco et al. J Clin Hypertens (Greenwich). 2006 Sep.

Abstract

This prospective, randomized trial evaluated the effect of monotherapy and different combination therapies on cardiovascular target organ damage and metabolic profile in 520 hypertensive patients. Patients were allocated to a single agent: carvedilol 25 mg, amlodipine 10 mg, enalapril 20 mg, or losartan 50 mg (groups C, A, E, and L, respectively). After 2 months (level 2), nonresponders received a low-dose thiazide diuretic, and after 4 months (level 3), amlodipine (groups E, C, and L) and carvedilol (group A). Twenty-four-hour blood pressure was significantly lowered in all treatment groups. Blood pressure control was more pronounced in patients receiving two or three drugs. At the end of the study, the carotid intima-media thickness decreased in group L (P<.01), left ventricular mass index in groups E and L (P<.05 and P<.001, respectively), with a concomitant reduction in cholesterol in group L (P<.03). Diastolic function improved significantly in group L (P<.05). This study describes the need to control blood pressure with two or more drugs in most hypertensive patients and illustrates good clinical outcomes, independent of blood pressure lowering, using combination therapy with losartan, low-dose thiazide, and amlodipine.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Treatment effect on left venticular (LV) mass index at the end of study. *P<01;†P<001.
Figure 2
Figure 2
Treatment effect on diastolic function and carotid intima‐media thickness (IMT) at the end of study. Em/Am indicates ratio of early to late diastolic velocities. *P<.05;†P<.01.
See this image and copyright information in PMC

References

    1. Kearney PM, Whelton M, Reynolds K, et al. Worldwide prevalence of hypertension: a systematic review. J Hypertens. 2004;22:11–19. - PubMed
    1. Sytkowski PA, D'Agostino RB, Belanger AJ, et al. Secular trends in long‐term sustained hypertension, long‐term treatment, and cardiovascular mortality. The Framingham Heart Study 1950 to 1990 . Circulation. 1996;93:697–703. - PubMed
    1. Marques‐Vidal P, Tuomilehto J. Hypertension awareness, treatment and control in the community: is the “rule of halves” still valid? J Hum Hypertens. 1997;11:213–220. - PubMed
    1. Dickerson JE, Hingorani AD, Ashby MJ, et al. Optimisation of antihypertensive treatment by crossover rotation of four major classes. Lancet. 1999;353:2008–2013. - PubMed
    1. Guidelines Committee . 2003 European Society of Hypertension‐European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens. 2003;21:1011–1053. - PubMed

Publication types

MeSH terms