Format

Send to

Choose Destination
Am J Hypertens. 2014 Jan;27(1):14-20. doi: 10.1093/ajh/hpt158. Epub 2013 Sep 5.

Differential effects of aliskiren/amlodipine combination and high-dose amlodipine monotherapy on endothelial function in elderly hypertensive patients.

Author information

1
Yanai Municipal Heigun Clinic, Yamaguchi, Japan.

Abstract

BACKGROUND:

The aim of this study was to compare the effects of direct renin inhibitor, aliskiren, and amlodipine combination therapy with those of high-dose amlodipine monotherapy on endothelial function in elderly hypertensive patients.

METHODS:

Participants included 105 patients (mean age 77 years) who had receive 5mg amlodipine for 4 weeks. Patients were allocated to the aliskiren/amlodipine group (AL/AM) or the high-dose amlodipine (AM) group. The AL/AM group received 150mg aliskiren in addition to 5mg amlodipine for 8 weeks; then the dose of aliskiren was doubled to 300mg for another 8 weeks. The AM group received 10mg amlodipine for 16 weeks. Of the 105 patients, 87 who underwent measurements of brachial flow-mediated vasodilation (FMD) and nitroglycerin-mediated vasodilation (NMD) before and after the study were included in the analysis.

RESULTS:

Blood pressure-lowering effects were similar in the 2 groups. Plasma renin activity significantly decreased in the AL/AM group (P < 0.001) but increased in the AM group (P < 0.001). Improvement of FMD was found in the AL/AM group (2.6% to 3.7%, P = 0.001) but not in the AM group, while NMD did not change in either group. The changes in 24-hour systolic blood pressure (r = -0.60, P < 0.001) and diastolic blood pressure (r = -0.46, P = 0.004) were significantly correlated with improvement of FMD in the AL/AM group but not in the AM group.

CONCLUSION:

Addition of aliskiren improved endothelial function in elderly hypertensive patients treated with amlodipine.

CLINICAL TRIAL REGISTRY NUMBER:

UMIN000010163.

KEYWORDS:

ambulatory blood pressure; blood pressure; calcium channel blocker; direct renin inhibitor; endothelial function; hypertension.

PMID:
24008122
DOI:
10.1093/ajh/hpt158
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center