Korean Circ J.  2005 Nov;35(11):854-859. 10.4070/kcj.2005.35.11.854.

A Randomized Crossover Study of the Additive Effect of Lercanidipine and Indapamide in Patients with the Mild to Moderate Hypertension

• Kim MK
• Park WJ
• Park CH

• KMID: 2297965
• DOI: http://doi.org/10.4070/kcj.2005.35.11.854

Abstract

BACKGROUND AND OBJECTIVES
There is evidence available from randomized control trials about the additive effects of combination regimens that are mainly based on diuretics and beta-blockers or ACE inhibitors. Yet there are some arguments about the effect of the combination of calcium channel blockers (CCBs) and diuretics. We aimed to study the blood pressure-lowering effects of lercanidipine, indapamide or a combination therapy on the home blood pressure (HBP) and the 24-hour ambulatory blood pressure (ABP), and we wanted to examine the agreement with using these two methods.
SUBJECTS AND METHODS
70 patients participated in this randomized open crossover design study. The treatments in each phase were 10 mg lercanidipine (L) and 1 mg indapamide (I), separately and also in combination (L+I). Each patient had their HBP checked twice during each phase and the 24h ABP was checked in two of the 3 phases. We also measured the agreement between the HBP and ABP by using a Bland-Altman plot.
RESULTS
58 patients (mean age: 49+/-9 (31-71) years; 37 males and 21 females) completed the study. The blood pressure was significantly reduced during all the active treatments compared with the baseline (L: 160.2+/-12/100.3+/-9 mmHg, I; 130.5+/-9.3/86.0+/-8.1 mmHg, 129.2+/-12.9/83.9+/-11.1 mmHg, L+I:124.9+/-10.9/81.3+/-8.5 mmHg, p<.000) and the BP for the combination therapy was also significantly less than those BPs for both the other monotherapies (L+I vs. L: p<.002, L+I vs. I: p<.01) by measuring the 24h ABP. The Bland-Altman plot showed+/-25 mmHg for the limit of agreement between both measurement methods.
CONCLUSION
CCB and diuretics were effective agents for treating hypertensive patients. As a combination therapy, the effects on blood pressure are additive. Poor agreement of the blood pressures with using the two measurement methods was observed.

Keyword

Hypertension; Ambulatory blood pressure monitoring; Calcium channel blockers; Diuretics, and drug effects

MeSH Terms

Angiotensin-Converting Enzyme Inhibitors
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Calcium Channel Blockers
Cross-Over Studies*
Diuretics
Humans
Hypertension*
Indapamide*
Male
Angiotensin-Converting Enzyme Inhibitors
Calcium Channel Blockers
Diuretics
Indapamide