KMID : 0368120050350110854
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Korean Circulation Journal 2005 Volume.35 No. 11 p.854 ~ p.859
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A Randomized Crossover Study of the Additive Effect of Lercanidipine and Indapamide in Patients with the Mild to Moderate Hypertension
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±è¹Î±Ô/Kim MK
¹Ú¿ìÁ¤/¹ÚÁ¾ÈÆ/Park WJ/Park CH
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Abstract
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Background and Objectives£ºThere is evidence available from randomized control trials about the additive effects of combination regimens that are mainly based on diuretics and ¥â-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£º70 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£º58 patients (mean age: 49¡¾9 (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¡¾12/100.3¡¾9 mmHg, I; 130.5¡¾9.3/86.0¡¾8.1 mmHg, 129.2¡¾12.9/83.9¡¾11.1 mmHg, L+I:124.9¡¾10.9/81.3¡¾8.5 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¡¾25 mmHg for the limit of agreement between both measurement methods.
Conclusion£ºCCB 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.
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