国产苯磺酸氨氯地平和络活喜治疗慢性肾功能不全合并高血压的对比研究

目的评价苯磺酸氨氯地平(压氏达)和络活喜对慢性肾功能不全合并高血压的患者的治疗效果和安全性。方法慢性肾功能不全(血清肌酐值265~442μmol.L-1)合并高血压患者(坐位DBP 90~105mmHg和/或坐位SBP≤170mmHg)63例被随机分为两组,分别服用压氏达或络活喜5mg每日1次,治疗4周末坐位DBP<80mmHg,且SBP<130mmHg者继续原剂量治疗至8周末;坐位DBP≥80mmHg或SBP≥130mmHg者剂量分别加倍至10mg每日1次治疗至8周末。分别观察患者服药前后血压、心率和肝肾功能等生化指标变化及其不良反应。结果 63例病人均完成8周的临床试验。与试验前比较,用药第4周起,两组患者的收缩压和舒张压均有显著性下降(P<0.01),降压总有效率压氏达组达87%,络活喜组达90%,若以血压为130/80mmHg为靶目标值则:压氏达组8周后12例(37.5%)达标;络活喜组10例(32.3%)达标。两组不良反应轻,试验结束时主要实验室检查指标与试验前比较无统计学差异。结论压氏达5~10mg每日1次是治疗慢性肾功能不全合并高血压的有效药物之一,且安全性好。     

厄贝沙坦治疗慢性肾功能不全合并高血压的效果评价

目的评价厄贝沙坦(安博维)治疗慢性肾功能不全合并轻中度肾性高血压的降压疗效和安全性。方法慢性肾功能不全(血清肌酐值265～442μmol/L)合并高血压患者40例,给予安博维150mg/d治疗4周,治疗4周末坐位DBP<80mm Hg,且SBP≤130mm Hg者继续原剂量治疗至8周末;坐位DBP>90mm Hg或SBP>140mm Hg者剂量分别加倍至300mg每日1次治疗至8周末。分别观察患者服药前后血压、心率和肝肾功能等生化指标变化及其不良反应。结果 40例患者均完成8周的临床试验。与试验前比较,用药第4周起,患者的收缩压和舒张压均有显著性下降(P<0.05),降压总有效率达85%。不良反应轻而少,试验结束时主要实验室检查指标与试验前比较无统计学差异。结论厄贝沙坦(安博维)150～300mg每日1次是治疗慢性肾功能不全合并轻中度肾性高血压有效药物之一,且安全性好。     

国产苯磺酸氨氯地平治疗慢性肾功能不全高血压的临床观察

目的 评价国产苯磺酸氨氯地平（兰迪）治疗慢性肾功能不全高血压的降压疗效和安全性。方法 慢性肾功能不全高血压病患者60例．给予苯磺酸氨氯地平5mg／d治疗4周，治疗4周末坐位DBP〈80mmHg，且SBP≤130mmHg者继续原剂量治疗至8周末；坐位DBP〉90mmHg或SBP〉140mmHg者剂量分别加倍至10mg每日1次治疗至8周末。分别观察患者服药前后血压、心率和肝肾功能等生化指标变化及其不良反应。结果 60例患者均完成8周的临床试验。与试验前比较．用药第4周起，患者的收缩压和舒张压均有显著性下降（P〈0．01），降压总有效率达83．3％。不良反应轻而少。结论 国产苯磺酸氨氯地平治疗慢性肾功能不全合并轻中度肾性高血压有效，且安全。     

左氨氯地平联合卡托普利治疗高血压疗效与安全性分析

目的 探讨左氨氯地平联合卡托普利治疗中度原发性高血压的临床效果与安全性.方法 以中度原发性高血压患者60例为研究对象,随机双盲分为左氨氯地平联合卡托普利缓释片组(观察组)、左氨氯地平组(对照组).患者在给药前经历2周的药物洗脱期.两组每天分别给予左氨氯地平、左氨氯地平联合卡托普利缓释片,给药4周后,平均坐位舒张压(SeDBP)≥90 mm Hg的患者加大给药剂量.比较两组的降压效果.结果 经过8周治疗后,观察组和对照组的SBP和DBP均显著下降,观察组SBP和DBP改善优于对照组,差异有统计学意义(P＜0.05).两组SBP、DBP的动态血压谷/峰(T/P)值均＞50％,SI均大于1.结论 同剂量下,左氨氯地平联合卡托普利治疗中度高血压优于单用左氨氯地平.     

左旋氨氯地平联合替米沙坦治疗老年糖尿病肾病合并高血压的疗效分析

目的探讨左旋氨氯地平联合替米沙坦治疗老年糖尿病肾病合并高血压患者的临床疗效和安全性。方法以收治的118例老年2型糖尿病肾病合并高血压患者为研究对象,随机分为观察组和对照组,各59例,对照组给予左旋氨氯地平治疗,观察组给予左旋氨氯地平联合替米沙坦治疗。比较两组患者肾功能、血压及不良反应的差异。结果治疗后,观察组24 h尿微白蛋白排泄率(UAER)为(73.8±10.8)μg/min、血肌酐(Scr)为(67.4±5.9)μmol/L,显著低于同期对照组(86.2±11.4)μg/min、(78.2±6.6)μmol/L,组间比较差异均具有统计学意义(P<0.05);治疗后,观察组收缩压(SBP)为(129.4±5.7)mm Hg、舒张压(DBP)为(79.2±4.1)mm Hg,显著低于同期对照组(139.6±6.3)mm Hg、(86.3±4.8)mm Hg,组间差异均具统计学意义(P<0.05);观察组不良反应发生率为6.8%,稍低于对照组的10.2%,组间比较差异无统计学意义(P>0.05)。结论左旋氨氯地平联合替米沙坦治疗老年糖尿病肾病合并高血压的临床效果显著,其可有效改善肾功能,降低血压水平,同时副作用也较少。     

络活喜联合复代文治疗2级原发性高血压的疗效观察

目的研究络活喜联合复代文治疗2级原发性高血压的疗效及安全性。方法选取100例2级原发性高血压患者,随机分为联合组（络活喜联合复代文治疗）和对照组（络活喜治疗）各50例,疗程16周,检测两组治疗前后收缩压（SBP）、舒张压（DBP）、脉压（PP）、肱踝脉搏波传导速度（BaPWV）、生化及电解质水平、不良反应,分析疗效及安全性。结果治疗16周后,两组SBP、DBP、PP、BaPWV明显降低,联合组SBP、DBP显著低于同期对照组,差异有统计学意义（P〈0．05）;联合组有效率明显高于同期对照组,两组均未见严重不良反应。结论络活喜联合复代文治疗2级原发性高血压疗效优于单用络活喜。     

坎地沙坦酯治疗轻中度原发性高血压疗效观察

目的评价坎地沙坦酯治疗轻中度原发性高血压的疗效、安全性。方法采用随机双盲分组试验,120例轻中度原发性高血压患者随机分为：坎地沙坦酯组（60例）和缬沙坦组（60例）,分别每天一次口服坎地沙坦酯8mg或缬沙坦80mg。药物治疗前、后行24h动态血压监测。结果①8周末,两组坐位收缩压（SBP）谷值及坐位舒张压（DBP）谷值均较基线明显下降,坎地沙坦酯组的SBP谷值及DBP谷值下降幅度大于缬沙坦组;②坎地沙坦酯降低轻中度高血压的有效率高于缬沙坦。结论①坎地沙坦酯8mg每天一次口服治疗轻中度原发性高血压安全、有效;②坎地沙坦酯8mg每天一次口服降压作用可维持24h。     

国产与进口苯磺酸左旋氨氯地平门诊治疗60例原发性高血压的临床疗效对照研究

目的比较了国产苯磺酸左旋氨氯地平(压氏达)与进口国产苯磺酸左旋氨氯地平(络活喜)门诊治疗原发性高血压的临床疗效、安全性及不良反应。方法采用随机、对照、双盲法观察国产苯磺酸左旋氨氯地平治疗轻、中度原发性高血压8周的疗效。60例原发性原发性高血压的门诊患者经2周的安慰剂洗脱期后随机分为两组,每组各30例,分别服用国产苯磺酸左旋氨氯地平5mg,2次/日或进口苯磺酸左旋氨氯地平(络活喜)5mg,1次/日,治疗8周。治疗开始前及治疗8周末进行相关实验室检查,每2周随访1次,记录受试者的血压、心率、不良反应。结果两组治疗前后收缩压与舒张压的下降均有显著性差异,国产苯磺酸左旋氨氯地平组(压氏达)有效率为83.6%,进口苯磺酸左旋氨氯地平组(络活喜)有效率为85.2%,组间比较无显著性差异(P>0.05)。两组患者不良反应轻微。结论国产苯磺酸左旋氨氯地平是治疗原发性高血压安全有效的药物,不良反应轻微,患者能很好耐受,且具有价格优势,是理想的一线降压药物。     

血管紧张素转化酶抑制剂加钙离子拮抗剂联合用药治疗模式对于轻、中度原发性高血压的临床疗效观察及其对血尿酸水平的影响

目的:比较卡托普利与氨氯地平联合用药与氨氯地平单独使用对于轻、中度原发性高血压患者的血压的调控及其血尿酸水平的影响。方法:选取本院门诊轻、中度原发性高血压患者80例进行随机、双盲的临床研究,所有患者经过2周清洗期后随机分为两组,其中联合用药组40例,采用卡托普利25 mg/次,每天2次,加氨氯地平5 mg/d处理;钙拮抗剂组40例,采用氨氯地平5 mg/d处理,为期8周。对比观察治疗前后血压变化情况。采用全自动生化分析仪检测治疗前后患者空腹血尿酸的变化情况。结果:联合用药组治疗4周后,平均坐位舒张压由治疗前的(98±7)mm Hg(1 mm Hg=0.133 kPa)下降至(92±8)mm Hg;治疗8周后,平均坐位舒张压为(86±11)mm Hg,治疗后较治疗前显著降低(P<0.05)。钙拮抗剂组,治疗前平均坐位舒张压为(96±8)mm Hg,治疗4周后,平均坐位舒张压为(95±7)mm Hg,与治疗前比较无统计学差异(P>0.05);治疗8周后,平均坐位舒张压为(90±8)mm Hg,较治疗前显著降低(P<0.05)。治疗8周后,两组间平均坐位舒张压下降幅度比较,联合用药组降低更为显著(P<0.05)。联合治疗与钙拮抗剂都能降低患者的血尿酸水平,联合用药组降低程度明显高于钙拮抗剂组(P<0.05)。结论:早期联合用药治疗轻、中度高血压患者,能够很好地控制轻、中度高血压,同时能够更好地发挥对重要脏器的保护作用。     

氨氯地平联合缬沙坦在轻中度高血压患者中的疗效观察

目的 探讨氨氯地平联合缬沙坦治疗轻中度高血压的效果.方法 根据治疗方法的不同将145例轻中度高血压患者分为A组（55例）、B组（45例）、C组（45例）,A组患者接受氨氯地平联合缬沙坦治疗,B组患者接受氨氯地平治疗,C组患者接受缬沙坦治疗.结果 治疗后,A组患者的SBP、DBP均显著低于B、C组（P＜0.05）,但B组与C组患者的SBP、DBP差异均无统计学意义（P＞0.05）;A组患者治疗显效率明显高于B、C组（P＜0.05）,但B组与C组患者的显效率差异无统计学意义（P＞0.05）.结论 氨氯地平联合缬沙坦治疗轻中度高血压的效果显著优于单一药物治疗,联合治疗方案是治疗轻中度高血压的理想方案.     

国产缬沙坦与进口培垛普利治疗原发性高血压的药物经济学分析

目的:比较国产缬沙坦(缬克)与进口培哚普利(雅施达)治疗轻中度原发性高血压的临床疗效和费用。方法:70例轻、中度原发性高血压患者随机口服国产缬沙坦80 mg.d-1或进口培哚普利4 mg.d-1,4周末诊室坐位舒张压≥90 mmHg者剂量分别加倍至160 mg.d-1和8 mg.d-1,继续服用4周。结果:治疗前两组间各参数基线水平差异无统计学意义(P>0.05),8周末缬沙坦组和培哚普利组总有效率分别为79.4%和80.6%(P>0.05),缬沙坦组收缩压和舒张压分别下降23.4 mmHg和11.7 mmHg,培哚普利组收缩压和舒张压分别下降22.8 mmHg和12.1 mmHg,(P>0.05)。缬沙坦组和培哚普利组每月人均治疗费用分别为105元和124元。结论:国产缬沙坦与进口培哚普利治疗原发性高血压疗效没有差别,但国产缬沙坦成本更低,服药依从性及耐受性更好。     

Long-term,open-label evaluation of the safety and efficacy of telmisartan 80 mg/hydrochlorothiazide 25 mg fixed-dose combination alone or with other antihypertensive medication

Objective: To assess the safety and efficacy of long-term treatment with telmisartan 80 mg/hydrochlorothiazide 25 mg (T80/H25) fixed-dose combination (FDC) in patients who completed a previous double-blind study, in which T80/H25 provided more blood pressure (BP) reduction and produced a BP response in more patients than did T80/H12.5 FDC. Methods: Patients received open-label T80/H25 for 24 weeks; further antihypertensive medication was permitted. Seated trough BP was measured at weeks 0, 4, 12 and 24. Results: Primary end point (seated trough diastolic BP (DBP) control (< 90 mmHg)) was achieved in 71.4% of patients versus 52.4% at baseline (n = 639). The improvement was apparent at week 4 and sustained thereafter. In patients who received more antihypertensive medication (111/639 (17.4%)), DBP control increased from 24.8% at baseline to 58.6% at week 24. Seated trough systolic BP (SBP)/DBP were reduced from 141.0/89.0 mmHg at baseline by 4.6/3.6 mmHg by week 24. SBP response (< 140 or ≥ 20 mmHg reduction from start of previous trial) and DBP response (< 90 or ≥ 10 mmHg reduction from start of previous trial) increased at week 24 versus baseline from 51.8 to 69.3% and from 55.8 to 74.3%, respectively. At week 24, 110 (17.4%) patients achieved normal SBP/DBP (< 130/< 85 mmHg) and a further 24 (3.8%) patients achieved optimal SBP/DBP (< 120/< 80 mmHg). T80/H25 FDC was well tolerated; drug-related adverse events occurred in 29 (4.5%) patients. Conclusion: T80/H25 provides sustained and well-tolerated additive BP control, given alone or as part of a multi-antihypertensive therapy.     

Comparison of monotherapy with irbesartan 150 mg or amlodipine 5 mg for treatment of mild-to-moderate hypertension.

OBJECTIVE. The primary objective of this study was to compare the antihypertensive efficacy of the angiotensin II receptor blocker irbesartan 150 mg and the calcium channel blocker amlodipine 5 mg in the treatment of patients with seated diastolic blood pressure (DBP) 95-110 mmHg. DESIGN. Multicentre, randomised, double-blind, comparative pilot study. METHODS. Subjects were 18-65 years of age, with DBP 95-110 mmHg, and of non-African American origin. Following a three week, single-blind, placebo lead-in period, 181 subjects were randomised in a 1:1 ratio to receive once-daily irbesartan 150 mg (n=89) or amlodipine 5 mg (n=92) for four weeks. Trough (24+/-3 hours post-dosing) BP measurements were obtained at baseline and at Weeks 2 and 4 under standardised, controlled conditions. Response was defined as DBP <90 mmHg or a reduction from baseline of 10 mmHg. RESULTS. After four weeks of treatment, the mean (+/-SE) decrease from baseline in DBP was 9.4+/-0.6 mmHg in the irbesartan group vs. 9.6+/-0.6 mmHg in the amlodipine group (p=0.806). The mean decrease from baseline in seated systolic BP was 12.2+/-1.0 mmHg in the irbesartan group vs. 12.0+/-1.0 mmHg in the amlodipine group (p=0.885). Overall, 62% of subjects in the irbesartan group and 63% in the amlodipine group had a response (p=0.609), and 54% and 56% of patients (p=0.596), respectively, had their DBP normalised (<90 mmHg). Adverse events were reported by 21.3% of patients receiving irbesartan and 20.7% receiving amlodipine. Conclusions. Irbesartan 150 mg demonstrated comparable efficacy to amlodipine 5 mg, thereby confirming its value as an antihypertensive treatment option in non-African American patients with DBP 95-110 mmHg.     

Comparison of benazepril-amlodipine and captopril-thiazide combinations in the management of mild-to-moderate hypertension

OBJECTIVE: To compare the efficacy and tolerability of benazepril 10 mg + amlodipine 5 mg combination (BZ+AM) versus captopril 50 mg + hydrochlorothiazide 25 mg (CP+HT) combination. MATERIAL: 405 outpatients with mild-to-moderate arterial hypertension not adequately controlled by a monotherapy with ACE inhibitors or calcium channel blockers or diuretics entered this multicenter, double-blind, randomized, parallel-group study. METHOD: After a 2-week placebo run-in, 397 patients with sitting diastolic (D) blood pressure (BP) > 95 mmHg and/or sitting systolic (S) BP > 160 mmHg were randomized to receive either BZ+AM (201 patients) or CP+HT (196 patients) once daily for 12 weeks. Main outcome measure was sitting DBP and SBP values at the end of active treatment. The response rate was defined as the proportion of patients with either a final sitting DBP < 90 mmHg or decreased by at least 10 mmHg or a sitting SBP < 150 mmHg or decreased by at least 20 mmHg from baseline. RESULTS: The DBP and SBP values obtained with BZ+AM were, respectively, 2.7 and 3.7 mmHg lower than those obtained with CP+HT (both p < 0.001 vs. CP+HT). The response rate in the BZ+AM group (94.8%) was better than that observed in the CP+HT group (86.0%, p = 0.004). The incidence of adverse events was similar with the 2 treatment regimens (17.9% for both). CONCLUSIONS: These data suggest a higher antihypertensive efficacy of the fixed combination BZ 10 mg+AM 5 mg as compared with CP 50 mg+HT 25 mg.     

Safety and antihypertensive efficacy of carvedilol and atenolol alone and in combination with hydrochlorothiazide

Carvedilol has been shown to be effective and safe in patients with essential hypertension when given as monotherapy. In this double-blind, randomized, group-comparative study, 2 groups of 59 patients with mild to moderate essential hypertension [median supine systolic/diastolic blood pressure at baseline (SBP/DBP), 168/105 mm Hg] were treated with either 25 mg carvedilol once daily (o. d.) or 50 mg atenolol o. d. for 4 weeks. Responders at 4 weeks (DBP, < 90=" mmhg)=" terminated=" the=" study.=" nonresponders=" continued=" the=" study.=" hydrochlorothiazide=" (hctz)=" was=" added=" at=" 25=" mg=" o.=" d.=" for=" a=" further=" 6=" weeks.=" the=" median=" blood=" pressure=" decreased=" under=" monotherapy=" with=" carvedilol=">n = 59) from 167/105 at baseline to 155/94 mmHg after 4 weeks, and in the atenolol group (n=59) it decreased from 168/105 to 162/97 mmHg. The patients who received carvedilol in combination with HCTZ and were evaluated for efficacy (n = 38) showed a decrease in SBP/DBP from 156/97 at the end of monotherapy to 145/88 mmHg after 10 weeks; the combination of atenolol with HCTZ (n = 44) reduced BP from 162/97 to 147/88. Both carvedilol and atenolol were safe when given either alone or in combination with HCTZ. In conclusion, after long-term administration, 25 mg carvedilol o. d. and 50 mg atenolol o. d. significantly reduced both SBP and DBP over 24 h. The addition of HCTZ led to a further increase in antihypertensive efficacy. Combined treatment with carvedilol or atenolol and HCTZ was very well tolerated, without hypotensive events or relevant changes in objective safety parameters.     

Efficacy and Safety of Olmesartan Medoxomil and Hydrochlorothiazide Compared with Benazepril and Amlodipine Besylate

BACKGROUND: Most patients with stage 2 hypertension require two or more antihypertensive agents in order to achieve the BP goals recommended in current treatment guidelines. Accordingly, combinations of two drugs with different mechanisms of antihypertensive action are widely used. OBJECTIVE: The aim of this randomized, double-blind, multicenter 12-week study was to compare the efficacy, safety, and tolerability of a combination of olmesartan medoxomil/hydrochlorothiazide (HCTZ) with that of benazepril plus amlodipine besylate in patients with stage 2 hypertension. METHODS: Patients were eligible for randomization following a 3- to 4-week placebo run-in period if they had either (i) mean seated DBP>or=90 mm Hg but<115 mm Hg and mean seated SBP>or=160 mm Hg but <200 mm Hg, or (ii) mean seated DBP>or=100 mm Hg but<115 mm Hg. The difference in mean seated SBP measured on two separate visits during the run-in period was required to beor=95 mm Hg and<115 mm Hg or SBP>145 mm Hg and相似文献   

依那普利-氢氯噻嗪治疗原发性高血压的临床疗效

目的:研究依那普利-氢氯噻嗪治疗中国人原发性高血压的临床疗效、安全性和耐受性。方法:采用随机、双盲、平行对照临床试验。126例轻、中度原发性高血压[95mmHg≤平均坐位舒张压(DBP)<110mmHg,平均坐位收缩压(SBP)<180mmHg(1mmHg=0.133kPa)],口服安慰剂2wk后, DBP仍在95-110mmHg的病人,随机分为3组,A组口服依那普利-氢氯噻嗪(10mg:6.25mg),qd;B组口服依那普利-氢氯噻嗪(10mg:12.5mg),qd;C组口服依那普利10mg,qd,4wk后如DBP≥90mmHg,各组剂量均加倍,疗程为8wk。安慰剂期末和治疗2,4,6,8wk测量坐位、立位血压和心率,记录不良反应。结果:8wk末,A组DBP由(99±4)mmHg降至(83±6)mmHg,降低(15±4)mmHg, SBP降低(18±14)mmHg;B组DBP由(100±5)mmHg降至(83±6)mmHg,降低(16±7)mmHg, SBP降低(17±16)mmHg;C组DBP由(97.0±2.0)mmHg降至(89±8)mmHg,降低(8±8)mmHg, SBP降低(3±14)mmHg。各组内DBP与治疗前相比均有非常显著差异(P<0.01),A,B两组组间差异无显著意义(P>0.05),A,B两组降压幅度优于C组,组间比较差异显著(P<0.05)。A,B,C组降压总有效率分别为86％,83％及60％,A,B两组比较无显著差异,分别与C组比较差异显著,优于C组(P<0.05)。3组主要不良反应为咳嗽、干咳,组间比较发生率无显著差异。结论:依那普利-氢氯噻嗪治疗轻、中度原发性高血压疗效优于单药制剂,6.25mg与12.5mg氢氯噻嗪的复方制剂降压疗效相似,复方制剂和单药一样安全,且耐受性好。     

坎地沙坦酯治疗轻中度高血压病人的疗效及安全性

目的：评价坎地沙坦酯治疗轻中度高血压病人的疗效及安全性。方法：人选48例轻中度高血压病人，经2周导人期后随机分人试验组和对照组各24例，按双盲、平行临床药理试验方法分别给予坎地沙坦酯8mg和氯沙坦50mg治疗。治疗4周后如不能有效控制血压，则将用药剂量加倍并维持到第8周末。检测病人治疗前、后不同时间的血压，心率，以及血、尿常规，肝、肾功能，并记录服药期间可能发生的不良事件。结果：试验组和对照组降压显效率均为100％，治疗后2周末收缩压(SBP)和舒张压(DBP)均已明显降低。此后血压继续下降，与治疗前相比，用药8周末试验组和对照组SBP分别下降20．3和16．4mmHg，DBP分别下降16．8和16．1mmHg。试验组中有1例病人服药期间出现头痛，1例病人感轻微胸闷和腹胀。两组病人血、尿常规，肝、肾功能均正常。结论：坎地沙坦酯治疗轻中度高血压病人降压效果良好，服用安全。     

Dose-Dependent Antihypertensive Efficacy and Tolerability of Perindopril in a Large, Observational, 12-Week, General Practice-Based Study

Background

Current guidelines recommend the use of full therapeutic dosages of antihypertensive agents, or combination therapy, to improve BP control of hypertensive patients in primary healthcare.

Objective

The aim of this study was to assess the dose-dependent antihypertensive efficacy and safety of perindopril 4 and 8 mg/day in the clinical setting.

Study Design and Setting

The CONFIDENCE study was a prospective, observational, multicenter trial. This was a real-world, clinic-based, outpatient study involving 880 general practitioners/primary-care clinics and 113 specialists in Canada.

Patients

The study included untreated or inadequately managed patients with hypertension (i.e. seated BP≥140/90 mmHg, or ≥130/80 mmHg in the presence of diabetes mellitus, renal disease, or proteinuria) without coronary artery disease (CAD).

Intervention

Treatment consisted of perindopril 4 mg/day, uptitrated to 8 mg/day as required for BP control at visit 2, for 12 weeks. Among the patients already being treated at baseline, perindopril either directly replaced all previous ACE inhibitors or angiotensin II type 1 receptor antagonists (angiotensin receptor blockers [ARBs]), or was added to antihypertensive treatment with calcium channel blockers (CCBs), diuretics, or β-adrenoceptor antagonists (β-blockers).

Main Outcomes Measures

The primary outcomes were the mean changes in BP from baseline following treatment with perindopril 4 and 8 mg/day as well as the proportion of patients achieving BP control (BP <140/90 mmHg, or <130/80 mmHg in diabetic patients) in the intent-to-treat (ITT) population. Secondary analyses included the incidence of adverse events and compliance.

Results

A total of 8298 hypertensive patients entered the study: 56% with newly diagnosed hypertension and 44% with uncontrolled hypertension. Mean SBP/DBP decreased significantly from baseline (152.5 ±10.8/89.5 ±9 mmHg) over 12 weeks (?18.5/?9.7 mmHg; p < 0.001). At visit 2, 23% of patients were uptitrated to perindopril 8 mg/day, which resulted in an additional mean 10.1/5.3 mmHg BP reduction; this reduction was even greater (15.1/5.7 mmHg) among a separate group of severely hypertensive patients (i.e. SBP >170 mmHg or DBP > 109 mmHg at baseline). Target BP was achieved in 54% of the ITT population. Both perindopril 4 mg/day and perindopril 8 mg/day were well tolerated and compliance was high throughout the study.

Conclusion

In the clinical outpatient setting, perindopril was found to be an effective dose-dependent and well tolerated antihypertensive treatment, with good compliance. Uptitration to the full therapeutic dosage of perindopril is an efficient approach for the management of a broad range of hypertensive patients without CAD.