Differential effects of lercanidipine/enalapril versus amlodipine/enalapril and hydrochlorothiazide/enalapril on target organ damage and sympathetic activation in non-obese essential hypertensive subjects. (30th September 2016)

• Record Type: Journal Article
• Authors: Tsioufis, Costas; Dimitriadis, Kyriakos; Mantzouranis, Emmanouil; Mani, Ilianna; Tousoulis, Dimitrios
• Is Part Of: Current medical research and opinion. Volume 32(2016)Supplement 2
• Page Start: 35
• Page End: 41
• Publication Date: 2016-09-30
• Subjects: Enalapril -- Hypertension -- Lercanidipine -- Muscle sympathetic nerve activity -- Target organ damage; Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1080/03007995.2016.1218839
• Languages: English
• ISSNs: 0300-7995

Abstract

Abstract: Objective: The aim of the present study was to compare the effects of the combination of lercanidipine/enalapril versus amlodipine/enalapril and hydrochlorothiazide/enalapril on blood pressure, target organ damage and sympathetic activation in patients with grade 2 essential hypertension. Research design and methods: This was a 3 month, randomized, blinded-endpoint study in essential hypertensive patients. Main outcome measures: Office and ambulatory blood pressure, arterial stiffness, urinary albumin to creatinine ratio, renal arterial resistive index, and muscle sympathetic nerve activity were evaluated at baseline, after a 2 week run-in placebo period, at 1 month and at 3 months. Results: In total, 56 patients were assigned to lercanidipine/enalapril ( n = 19), enalapril/amlodipine ( n = 18) and hydrochlorothiazide/enalapril ( n = 19). Each pharmacological combination tested was effective in reducing office blood pressure at 1 month and 3 months, and 24 h ambulatory blood pressure at 3 months. Renal arterial resistive index (RI) significantly improved at 1 month and 3 months compared with baseline in all groups. However in the lercanidipine/enalapril and hydrochlorothiazide/enalapril groups, RI was favorably reduced (0.53 ± 0.03 and 0.54 ± 0.04 respectively, p < 0.05) in comparison with the enalapril/amlodipine RI value (0.57 ± 0.03) at 3 months. Moreover, after 3 months of treatment, a significant decrease (by -5.47 bursts/min) ( p < 0.05) in muscle sympathetic nerve activity was observed in the lercanidipine/enalapril group (50.79 ± 6.49) compared with baseline (56.26 ± 6.05), while no differences were detected in the amlodipine/enalapril and hydrochlorothiazide/enalapril groups. Conclusions: Our study provides evidence of the efficacy of the lercanidipine/enalapril combination in ameliorating hypertension-related target organ damage and in reducing sympathetic overdrive.