The effect of lercanidipine or lercanidipine/enalapril combination on blood pressure in treatment-naïve patients with stage 1 or 2 systolic hypertension.

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL Pragmatic and Observational Research Pub Date : 2019-01-22 eCollection Date: 2019-01-01 DOI:10.2147/POR.S186070
Brian Rayner
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Abstract

Purpose: To describe the efficacy of a stratified approach on automatic office blood pressure (BP), 24-hour ambulatory BP, and BP variability (BPV) in treatment-naïve patients with systolic hypertension using lercanidipine for stage 1 and lercanidipine/enalapril for stage 2.

Patients and methods: This was an open-label, prospective interventional study conducted in 22 general practices in South Africa. Treatment-naïve patients with stage 1 hypertension received lercanidipine 10 mg and patients with stage 2 received lercanidipine 10 mg/enalapril 10 mg. After 6 weeks, patients not reaching target (<140/90 mmHg) were up-titrated to lercanidipine 10 mg/enalapril 10 mg or lercanidipine 10 mg/enalapril 20 mg, respectively, for a further 6 weeks. Office BP was determined at each visit, and 24-hour ambulatory BP monitor (ABPM) at baseline and 12 weeks. The primary end point was changes in office BP, and secondary end points were changes in 24-hour ABPM and BPV.

Results: Of the 198 patients, 48% had stage 1 and 52% stage 2 hypertension. The mean age was 55 years, body mass index was 29.2 kg/m2, 48.5% were female, and 15.1% were diabetic. The mean (SD) office SBP and DBP at baseline, 6 weeks, and 12 weeks was 158.2 (13.8), 141.6 (11.1), and 138.7 (16.7) mmHg (P<0.00001), and 92.2 (10.6), 84.6 (11.1), and 82 (13.3) mmHg (P<0.00001), respectively. The mean (SD) systolic and diastolic daytime ABPM at baseline and 12 weeks was 157 (16.63) and 142 (14.41) mmHg (P<0.0001) and 88 (12.34) and 81 (10.79) mmHg (P<0.0001), and the nighttime ABPM was 146 (15.68) and 133 (13.94) mmHg (P<0.0001) and 79.5 (11.64) and 72.5 (10.05) mmHg (P<0.009), respectively. There were few adverse events.

Conclusion: Lercanidipine and lercanidipine/enalapril for stage 1 or 2 hypertension highly improves office SBP and DBP, overall 24-hour BP, daytime BP, and nighttime BP, also reducing BPV with few adverse effects.

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来卡尼地平或来卡尼地平/依那普利联合用药对treatment-naïve期1或2期收缩期高血压患者血压的影响
目的:描述分层方法对收缩期高血压treatment-naïve患者的自动办公室血压(BP)、24小时动态血压和血压变异性(BPV)的疗效,这些患者使用莱卡尼地平治疗1期,使用莱卡尼地平/依那普利治疗2期。患者和方法:这是一项开放标签的前瞻性介入研究,在南非的22家全科医院进行。Treatment-naïve 1期高血压患者接受来卡尼地平10mg, 2期患者接受来卡尼地平10mg /依那普利10mg。结果:198例患者中,1期高血压占48%,2期高血压占52%。平均年龄55岁,体重指数29.2 kg/m2,女性48.5%,糖尿病患者15.1%。基线、6周和12周时办公室收缩压和舒张压的平均值(SD)分别为158.2(13.8)、141.6(11.1)和138.7 (16.7)mmHg (ppppppp)。结论:来卡尼地平和来卡尼地平/依那普利治疗1期或2期高血压可显著改善办公室收缩压和舒张压、总24小时血压、白天血压和夜间血压,同时降低BPV,副作用少。
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Pragmatic and Observational Research
Pragmatic and Observational Research MEDICINE, GENERAL & INTERNAL-
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期刊介绍: Pragmatic and Observational Research is an international, peer-reviewed, open-access journal that publishes data from studies designed to closely reflect medical interventions in real-world clinical practice, providing insights beyond classical randomized controlled trials (RCTs). While RCTs maximize internal validity for cause-and-effect relationships, they often represent only specific patient groups. This journal aims to complement such studies by providing data that better mirrors real-world patients and the usage of medicines, thus informing guidelines and enhancing the applicability of research findings across diverse patient populations encountered in everyday clinical practice.
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