Differential effects of lercanidipine/enalapril versus amlodipine/enalapril and hydrochlorothiazide/enalapril on target organ damage and sympathetic activation in non-obese essential hypertensive subjects

• Published in: Current medical research and opinion 2016-10, Vol.32 (sup2), p.35-41
• Main Authors: Tsioufis, Costas, Dimitriadis, Kyriakos, Mantzouranis, Emmanouil, Mani, Ilianna, Tousoulis, Dimitrios
• Format: Article
• Language: English
• Subjects: Adult; Amlodipine - administration & dosage; Antihypertensive Agents - administration & dosage; Blood Pressure - drug effects; Blood Pressure Monitoring, Ambulatory; Dihydropyridines - administration & dosage; Double-Blind Method; Drug Therapy, Combination; Enalapril; Enalapril - administration & dosage; Female; Humans; Hydrochlorothiazide - administration & dosage; Hydrochlorothiazide - therapeutic use; Hypertension; Hypertension - drug therapy; Kidney - drug effects; Lercanidipine; Male; Middle Aged; Muscle sympathetic nerve activity; Sympathetic Nervous System - drug effects; Target organ damage; Vascular Stiffness - drug effects
• ISSN: 0300-7995; 1473-4877
• DOI: 10.1080/03007995.2016.1218839

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