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Roberto Fogari - One of the best experts on this subject based on the ideXlab platform.
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effect of telmisartan addition to amlodipine on Ankle Edema development in treating hypertensive patients
Expert Opinion on Pharmacotherapy, 2011Co-Authors: Roberto Fogari, Amedeo Mugellini, Annalisa Zoppi, Pamela Maffioli, P Lazzari, Giuseppe DerosaAbstract:Objective: The objective of this research was to evaluate the effect of telmisartan addition to amlodipine, on peripheral Edema in hypertensive patients. Research design and methods: Seventy-five outpatients were randomized to amlodipine (A) 10 mg or telmisartan (T) 80 mg, or amlodipine 10 mg plus telmisartan 80 mg, for 6 weeks, in three crossover periods. Main outcome measures: Blood pressure, Ankle foot volume (AFV) and pretibial subcutaneous tissue pressure (PSTP) were evaluated, as were plasma norepinephrine and plasma active renin (PAR). Results: Amlodipine–telmisartan combination induced greater SBP/DBP reduction (−28.1/21.7 mmHg, p < 0.0001 vs baseline) compared with monotherapy with both amlodipine and telmisartan. Amlodipine monotherapy increased AFV by 26.7%, and PSTP by 83.2% (both p < 0.01). Adding telmisartan to amlodipine produced a significantly lesser increase in both AFV (+7.9%, p < 0.01 vs amlodipine) and PSTP (+23.8%, p < 0.01 vs amlodipine). Plasma norepinephrine levels were increased ...
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effect of aliskiren addition to amlodipine on Ankle Edema in hypertensive patients a three way crossover study
Expert Opinion on Pharmacotherapy, 2011Co-Authors: Roberto Fogari, Amedeo Mugellini, Annalisa Zoppi, Pamela Maffioli, P Lazzari, Claudio Maria Monti, Giuseppe DerosaAbstract:Objective: The aim of this study was to assess the effect of aliskiren and amlopidine on Ankle-foot volume (AFV) and pretibial subcutaneous tissue pressure (PSTP). Research design and methods: After 4-week placebo, 120 outpatients with grade 1 – 2 hypertension were randomized to amlodipine 10 mg or aliskiren 300 mg or their combination for 8 weeks in three crossover periods. At the end of each treatment, blood pressure, AFV, PSTP, plasma renin activity (PRA) and norepinephrine were assessed. Results: Both monotherapies similarly reduced systolic blood pressure (SBP; p < 0.001) and diastolic blood pressure (DBP; p < 0.001), but the reduction was greater with amlodipine/aliskiren combination (SBP: - 24.6 mmHg, p < 0.001 vs monotherapy; DBP: -20.9 mmHg, p < 0.01 vs monotherapy). Amlodipine increased both AFV (+ 28.4%, p < 0.01) and PSTP (+ 80.4%, p < 0.01), while the combination produced a less marked increase in AFV (+ 6.6%, p < 0.01 vs amlodipine) and PSTP (+ 20.1%, p < 0.01 vs amlodipine). Plasma norepine...
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effect of valsartan or olmesartan addition to amlodipine on Ankle Edema in hypertensive patients
Advances in Therapy, 2010Co-Authors: Roberto Fogari, Amedeo Mugellini, Gian Domenico Malamani, L Corradi, Paola Preti, Annalisa Zoppi, Giuseppe DerosaAbstract:Introduction The objective of this study was to compare the effect on Ankle Edema of adding valsartan (V) or olmesartan (O) to amlodipine (A) in the treatment of hypertension.
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Rationale for use of the fixed combination of delapril and manidipine in the treatment of hypertension in patients with diabetes mellitus
Clinical Therapeutics, 2007Co-Authors: Roberto FogariAbstract:Abstract Background: The fixed combination of the angiotensin-converting enzyme (ACE) inhibitor delapril and the dihydropyridine calcium channel blocker manidipine is a new oral, QD antihypertensive regimen that may have a role in the management of hypertension in patients with diabetes mellitus (DM). Objective: The purpose of this article was to briefly review the evidence regarding the efficacy, tolerability, and potential clinical benefits of delapril and manidipine (as single agents and in combination) in hypertensive patients with type 2 DM. Methods: A MEDLINE search (1992-2006) was performed using delapril and manidipine as search terms to identify key studies on the pharmacokinetics, efficacy, and tolerability of these agents in hypertensive patients with DM. Additional nonindexed studies and meeting abstracts were identified by examining the reference citations from the studies in the MEDLINE output. Results: Delapril/manidipine offers several potential benefits in hypertensive patients with type 2 DM. In clinical trials, the combination was as effective as ramipril/hydrochlorothiazide (HCTZ), valsartan/HCTZ, olmesartan/HCTZ, and irbesartan/HCTZ. Delapril/manidipine is associated with a low incidence of Ankle Edema and does not appear to have an orthostatic hypotensive effect. The combination has renoprotective benefits, reducing microalbuminuria and stabilizing serum creatinine levels. Delapril/manidipine does not appear to affect glucose metabolism or glycemic control. In addition, there is evidence that the combination increases insulin sensitivity, improves coagulation (via an increase in tissue plasminogen activity), and reduces left ventricular mass in diabetic hypertensive patients. Conclusion: The properties of delapril and manidipine make this ACE inhibitor/calcium channel blocker combination a valuable treatment option for hypertension in patients with type 2 DM, a population that is particularly difficult to treat.
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Effect on the development of Ankle Edema of adding delapril to manidipine in patients with mild to moderate essential hypertension: a three-way crossover study.
Clinical therapeutics, 2007Co-Authors: Roberto Fogari, A Zoppi, E Fogari, Amedeo Mugellini, Andrea Rinaldi, G.d. Malamani, Tiziano PerroneAbstract:Abstract Background: Use of the combination of an angiotensinconverting enzyme inhibitor (ACEI) and a calcium channel blocker (CCB) is considered a rational approach in patients whose hypertension is not controlled by monotherapy, providing better blood pressure (BP) control than the individual components with a lower incidence of adverse effects. In particular, such combinations have been found to reduce the incidence of Ankle Edema, the most common adverse effect of dihydropyridine annhypertensives. Objective: The present study was undertaken to evaluate the effect on the development of Ankle Edema of adding the ACEI delapril to the CCB manidipine in patients with mild to moderate essential hypertension. Methods: Patients between the ages of 30 and 70 years who had mild to moderate hypertension (diastolic BP [DBP] >90 and Results: The study enrolled 40 patients with previously untreated hypertension (21 women, 19 men). Both manidipine and delapril monotherapy were associated with significant reductions from baseline in systolic BP (SBP) (mean [SD], -17.3 [4] and -14.8 [4] mm Hg, respectively; both, P P P P P P P P Conclusion: In these patients with mild to moderate essential hypertension, the addition of delapril to manidipine partially counteracted the manidipine-induced microcirculatory changes responsible for Ankle Edema.
Amedeo Mugellini - One of the best experts on this subject based on the ideXlab platform.
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effect of telmisartan addition to amlodipine on Ankle Edema development in treating hypertensive patients
Expert Opinion on Pharmacotherapy, 2011Co-Authors: Roberto Fogari, Amedeo Mugellini, Annalisa Zoppi, Pamela Maffioli, P Lazzari, Giuseppe DerosaAbstract:Objective: The objective of this research was to evaluate the effect of telmisartan addition to amlodipine, on peripheral Edema in hypertensive patients. Research design and methods: Seventy-five outpatients were randomized to amlodipine (A) 10 mg or telmisartan (T) 80 mg, or amlodipine 10 mg plus telmisartan 80 mg, for 6 weeks, in three crossover periods. Main outcome measures: Blood pressure, Ankle foot volume (AFV) and pretibial subcutaneous tissue pressure (PSTP) were evaluated, as were plasma norepinephrine and plasma active renin (PAR). Results: Amlodipine–telmisartan combination induced greater SBP/DBP reduction (−28.1/21.7 mmHg, p < 0.0001 vs baseline) compared with monotherapy with both amlodipine and telmisartan. Amlodipine monotherapy increased AFV by 26.7%, and PSTP by 83.2% (both p < 0.01). Adding telmisartan to amlodipine produced a significantly lesser increase in both AFV (+7.9%, p < 0.01 vs amlodipine) and PSTP (+23.8%, p < 0.01 vs amlodipine). Plasma norepinephrine levels were increased ...
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effect of aliskiren addition to amlodipine on Ankle Edema in hypertensive patients a three way crossover study
Expert Opinion on Pharmacotherapy, 2011Co-Authors: Roberto Fogari, Amedeo Mugellini, Annalisa Zoppi, Pamela Maffioli, P Lazzari, Claudio Maria Monti, Giuseppe DerosaAbstract:Objective: The aim of this study was to assess the effect of aliskiren and amlopidine on Ankle-foot volume (AFV) and pretibial subcutaneous tissue pressure (PSTP). Research design and methods: After 4-week placebo, 120 outpatients with grade 1 – 2 hypertension were randomized to amlodipine 10 mg or aliskiren 300 mg or their combination for 8 weeks in three crossover periods. At the end of each treatment, blood pressure, AFV, PSTP, plasma renin activity (PRA) and norepinephrine were assessed. Results: Both monotherapies similarly reduced systolic blood pressure (SBP; p < 0.001) and diastolic blood pressure (DBP; p < 0.001), but the reduction was greater with amlodipine/aliskiren combination (SBP: - 24.6 mmHg, p < 0.001 vs monotherapy; DBP: -20.9 mmHg, p < 0.01 vs monotherapy). Amlodipine increased both AFV (+ 28.4%, p < 0.01) and PSTP (+ 80.4%, p < 0.01), while the combination produced a less marked increase in AFV (+ 6.6%, p < 0.01 vs amlodipine) and PSTP (+ 20.1%, p < 0.01 vs amlodipine). Plasma norepine...
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effect of valsartan or olmesartan addition to amlodipine on Ankle Edema in hypertensive patients
Advances in Therapy, 2010Co-Authors: Roberto Fogari, Amedeo Mugellini, Gian Domenico Malamani, L Corradi, Paola Preti, Annalisa Zoppi, Giuseppe DerosaAbstract:Introduction The objective of this study was to compare the effect on Ankle Edema of adding valsartan (V) or olmesartan (O) to amlodipine (A) in the treatment of hypertension.
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Effect on the development of Ankle Edema of adding delapril to manidipine in patients with mild to moderate essential hypertension: a three-way crossover study.
Clinical therapeutics, 2007Co-Authors: Roberto Fogari, A Zoppi, E Fogari, Amedeo Mugellini, Andrea Rinaldi, G.d. Malamani, Tiziano PerroneAbstract:Abstract Background: Use of the combination of an angiotensinconverting enzyme inhibitor (ACEI) and a calcium channel blocker (CCB) is considered a rational approach in patients whose hypertension is not controlled by monotherapy, providing better blood pressure (BP) control than the individual components with a lower incidence of adverse effects. In particular, such combinations have been found to reduce the incidence of Ankle Edema, the most common adverse effect of dihydropyridine annhypertensives. Objective: The present study was undertaken to evaluate the effect on the development of Ankle Edema of adding the ACEI delapril to the CCB manidipine in patients with mild to moderate essential hypertension. Methods: Patients between the ages of 30 and 70 years who had mild to moderate hypertension (diastolic BP [DBP] >90 and Results: The study enrolled 40 patients with previously untreated hypertension (21 women, 19 men). Both manidipine and delapril monotherapy were associated with significant reductions from baseline in systolic BP (SBP) (mean [SD], -17.3 [4] and -14.8 [4] mm Hg, respectively; both, P P P P P P P P Conclusion: In these patients with mild to moderate essential hypertension, the addition of delapril to manidipine partially counteracted the manidipine-induced microcirculatory changes responsible for Ankle Edema.
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comparative effect of lercanidipine and nifedipine gastrointestinal therapeutic system on Ankle volume and subcutaneous interstitial pressure in hypertensive patients a double blind randomized parallel group study
Current Therapeutic Research-clinical and Experimental, 2000Co-Authors: Roberto Fogari, E Fogari, Gian Domenico Malamani, Paola Preti, Annalisa Zoppi, Alessandro Vanasia, Amedeo MugelliniAbstract:Abstract Background: Ankle Edema is one of the most common side effects of antihypertensive treatment with calcium channel blockers (CCBs). The incidence of Edema is higher with dihydropyridines than with verapamil or diltiazem. Objective: The aim of this study was to compare the effect of antihypertensive treatment with the new CCB lercanidipine versus nifedipine gastrointestinal therapeutic system (GITS) on Ankle-foot volume (AFV) and on pretibial subcutaneous tissue pressure (PSTP), considered objective measures of CCB-induced Ankle Edema. Methods: Patients with mild to moderate hypertension (diastolic >90 mm Hg and Results: Sixty patients (34 men and 26 women) aged 36 to 70 years were enrolled. Lercanidipine and nifedipine GITS produced similar reductions in systolic and diastolic BP (lercanidipine, −18.7/11.8 mm Hg; nifedipine GITS, −18.8/11.5 mm Hg; P P 2 O) compared with nifedipine GITS (AFV, 284.2 mL; PSTP, 1.8 cm H 2 O). In both treatment groups, correlation analysis showed an inverse relationship, although to a different degree, between AFV and PSTP changes, but not between absolute values of AFV and PSTP during treatment. AFV increase was greater and PSTP increase was lower with increasing age, which suggests a role for age in the type of tissue response to a stimulus for Edema formation. No relationship was found between AFV and PSTP changes and BP reduction. Conclusions: These data suggest that lercanidipine produces significantly less increases in AFV and PSTP, 2 objective measures of Edema formation, than nifedipine GITS.
Giuseppe Derosa - One of the best experts on this subject based on the ideXlab platform.
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effect of telmisartan addition to amlodipine on Ankle Edema development in treating hypertensive patients
Expert Opinion on Pharmacotherapy, 2011Co-Authors: Roberto Fogari, Amedeo Mugellini, Annalisa Zoppi, Pamela Maffioli, P Lazzari, Giuseppe DerosaAbstract:Objective: The objective of this research was to evaluate the effect of telmisartan addition to amlodipine, on peripheral Edema in hypertensive patients. Research design and methods: Seventy-five outpatients were randomized to amlodipine (A) 10 mg or telmisartan (T) 80 mg, or amlodipine 10 mg plus telmisartan 80 mg, for 6 weeks, in three crossover periods. Main outcome measures: Blood pressure, Ankle foot volume (AFV) and pretibial subcutaneous tissue pressure (PSTP) were evaluated, as were plasma norepinephrine and plasma active renin (PAR). Results: Amlodipine–telmisartan combination induced greater SBP/DBP reduction (−28.1/21.7 mmHg, p < 0.0001 vs baseline) compared with monotherapy with both amlodipine and telmisartan. Amlodipine monotherapy increased AFV by 26.7%, and PSTP by 83.2% (both p < 0.01). Adding telmisartan to amlodipine produced a significantly lesser increase in both AFV (+7.9%, p < 0.01 vs amlodipine) and PSTP (+23.8%, p < 0.01 vs amlodipine). Plasma norepinephrine levels were increased ...
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effect of aliskiren addition to amlodipine on Ankle Edema in hypertensive patients a three way crossover study
Expert Opinion on Pharmacotherapy, 2011Co-Authors: Roberto Fogari, Amedeo Mugellini, Annalisa Zoppi, Pamela Maffioli, P Lazzari, Claudio Maria Monti, Giuseppe DerosaAbstract:Objective: The aim of this study was to assess the effect of aliskiren and amlopidine on Ankle-foot volume (AFV) and pretibial subcutaneous tissue pressure (PSTP). Research design and methods: After 4-week placebo, 120 outpatients with grade 1 – 2 hypertension were randomized to amlodipine 10 mg or aliskiren 300 mg or their combination for 8 weeks in three crossover periods. At the end of each treatment, blood pressure, AFV, PSTP, plasma renin activity (PRA) and norepinephrine were assessed. Results: Both monotherapies similarly reduced systolic blood pressure (SBP; p < 0.001) and diastolic blood pressure (DBP; p < 0.001), but the reduction was greater with amlodipine/aliskiren combination (SBP: - 24.6 mmHg, p < 0.001 vs monotherapy; DBP: -20.9 mmHg, p < 0.01 vs monotherapy). Amlodipine increased both AFV (+ 28.4%, p < 0.01) and PSTP (+ 80.4%, p < 0.01), while the combination produced a less marked increase in AFV (+ 6.6%, p < 0.01 vs amlodipine) and PSTP (+ 20.1%, p < 0.01 vs amlodipine). Plasma norepine...
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effect of valsartan or olmesartan addition to amlodipine on Ankle Edema in hypertensive patients
Advances in Therapy, 2010Co-Authors: Roberto Fogari, Amedeo Mugellini, Gian Domenico Malamani, L Corradi, Paola Preti, Annalisa Zoppi, Giuseppe DerosaAbstract:Introduction The objective of this study was to compare the effect on Ankle Edema of adding valsartan (V) or olmesartan (O) to amlodipine (A) in the treatment of hypertension.
M R Cesarone - One of the best experts on this subject based on the ideXlab platform.
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efficacy of topical treatment with aescin essential phospholipids gel on capillary fragility
Angiology, 2004Co-Authors: M R Cesarone, G Belcaro, A Ricci, A Di Renzo, M DugallAbstract:The aim of this efficacy study was to evaluate local capillary fragility with the vacuum suction chamber (VSC) in patients with chronic venous hypertension due to chronic venous disease. All included patients had important Ankle Edema due to venous hypertension because of a post-thrombotic syndrome. Severe, deep, venous incompetence was present. The VSC was applied onto the internal perimalleolar region. Negative pressure was applied for a variable period of 2, 4, 6, 8, and 10 minutes. The negative pressure in the plastic chamber (2 cm in diameter)-as previously described-was 50 mm Hg. A group of ten patients (mean age 56 years; SD 4; M:F = 5:5) were studied. The tests were repeated in steps of two tests on different days. Between the two tests, with the VSC applied in different skin areas of the perimalleolar region, an interval of at least 30 minutes was observed.
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treatment of Edema and increased capillary filtration in venous hypertension with total triterpenic fraction of centella asiatica a clinical prospective placebo controlled randomized dose ranging trial
Angiology, 2001Co-Authors: M T De Sanctis, G Belcaro, L Incandela, M R Cesarone, Maura Griffin, E Ippolito, M CacchioAbstract:The variation of capillary filtration rate (CFR), Ankle circumference (AC), and Ankle Edema (AE) was evaluated in three groups of patients with venous hypertension (ambulatory venous pressure >42 mm Hg) and in a group of normal subjects before and after treatment for 4 weeks with total triterpenic fraction of Centella asiatica (TTFCA), a venoactive drug acting on the microcirculation and on capillary permeability. Group A (20 patients)was treated with TTFCA 60 mg thrice daily, group B (20 patients) was treated with 30 mg thrice daily; group C (12 patients) was treated with placebo; and group D (10 normal subjects) was treated with TTFCA 60 mg thrice daily in a randomized study. Capillary filtration rate was assessed by venous occlusion plethysmography, Ankle Edema by a new system called AET (Ankle Edema tester). Subjective symptoms of venous hypertension were assessed by an analogue scale line considering four symptoms: swelling sensation, restless lower extremity, pain and cramps, and tiredness. CFR, AC, and AE were significantly higher in patients in comparison with normal subjects. After 4 weeks of TTFCA treatment, there was a significant decrease of CFR, AC, and AET time in patients. This was also greater in the higher dose group. No significant change was observed in the placebo group and in normal subjects treated with TTFCA. Symptoms were also significantly improved in the two groups treated with the active drug according to the dose. No significant changes were observed in the placebo group. In conclusion, the improvement of signs and symptoms by TTFCA observed in patients with venous hypertension was well correlated with the improvement of CFR and Ankle Edema. Dose ranging showed that 180 mg/day is more effective in improving symptoms and CFR.
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capillary filtration in venous hypertension evaluation with the vacuum suction chamber device and strain gauge plethysmography
Angiology, 2001Co-Authors: Gianni Belcaro, M T De Sanctis, L Incandela, M R Cesarone, Maura Griffin, A Rulo, M CacchioAbstract:The aim of this study was to evaluate local capillary filtration with the vacuum suction chamber (VSC) and the rate of Ankle swelling (RAS) in patients with Ankle Edema due to venous hypertension before and after treatment with oral TTFCA (60 mg tablets twice daily) for 4 weeks. Strain-gauge plethysmography (SGP) was used to assess RAS and local capillary filtration was studied with the VSC (applied on the perimalleolar region); the disappearance of the weal was measured (minutes). Fifty patients with chronic venous insufficiency and Edema were included (M:F=25:25) after informed consent and randomized into a treatment (mean age 43; SD 7) and a control (mean age 44; SD 8) group. Compliance was very good (100% completed the 4-week trial); no side effects were observed. The two groups were comparable for age/sex distribution. Values of RAS and VSC time were comparable in the two groups, at inclusion. After 4 weeks there were no changes in the control group. A significant reduction was observed in the treatment (RAS decreased to 34% of the initial value; the VSC time decreased 48%; p < 0.02). Treatment with TTFCA in chronic venous insufficiency is useful as soon as Edema is detected to control the progressive alterations leading to ulcerations. This action is produced by complex actions on the microcirculation reducing and controlling Edema and modulating collagen synthesis. This results in an improvement of the microcirculation, skin and subcutaneous tissue perfusion and functions.
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capillary filtration and Ankle Edema in patients with venous hypertension effects of daflon
Angiology, 1993Co-Authors: M R Cesarone, M T De Sanctis, G Laurora, G BelcaroAbstract:Capillary filtration (CF) was assessed in 43 patients with venous hypertension and in 10 normal subjects by means of strain gauge plethysmography. The patients were then divided into two treatment groups; 22 were treated with Daflon, 500 mg tid, and 21 with Daflon, 500 mg bid. The normal subjects were also treated (500 mg tid). After four weeks CF was significantly decreased in all subjects, the decrease being higher in the high-dose groups. CF did not significantly change in normal subjects. In conclusion Daflon decreases CF in subjects with venous hypertension and the CF decrease is dose related.
Manuel Luque Otero - One of the best experts on this subject based on the ideXlab platform.
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REVIEW Manidipine–delapril combination in the management of hypertension
2013Co-Authors: Manuel Luque OteroAbstract:Abstract: High blood pressure (BP) is the major cardiovascular risk factor and the main cause of death around the world. Control of blood pressure reduces the high mortality associated with hypertension and the most recent guidelines recommend reducing arterial BP values below 140/90 mmHg for all hypertensive patients (130/80 in diabetics) as a necessary step to reduce global cardiovascular risk, which is the fundamental objective of the treatment. To achieve these target BP goals frequently requires combination therapy with two or more antihypertensive agents. Although the combination of a diuretic and an angiotensin converting enzyme inhibitor (ACEI) is the most commonly used in the clinical practice, the combination of an ACEI and a calcium channel blocker may have an additive antihypertensive effect, a favorable effect on the metabolic profile, and an increased target organ damage protection. The new oral fixed combination manidipine 10 mg/delapril 30 mg has a greater antihypertensive effect than both components of the combination separately, and in non-responders to monotherapy with manidipine or delapril the average reduction of systolic and diastolic BP is 16/10 mmHg. The combination is well tolerated and the observed adverse effects are of the same nature as those observed in patients treated with the components as monotherapy. However, combination therapy reduces the incidence of Ankle Edema in patients treated with manidipine
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Manidipine–delapril combination in the management of hypertension
Dove Medical Press, 2007Co-Authors: Manuel Luque OteroAbstract:Manuel Luque OteroHypertension Unit, Hospital Clinico San Carlos, Complutense University, Madrid, SpainAbstract: High blood pressure (BP) is the major cardiovascular risk factor and the main cause of death around the world. Control of blood pressure reduces the high mortality associated with hypertension and the most recent guidelines recommend reducing arterial BP values below 140/90 mmHg for all hypertensive patients (130/80 in diabetics) as a necessary step to reduce global cardiovascular risk, which is the fundamental objective of the treatment. To achieve these target BP goals frequently requires combination therapy with two or more antihypertensive agents. Although the combination of a diuretic and an angiotensin converting enzyme inhibitor (ACEI) is the most commonly used in the clinical practice, the combination of an ACEI and a calcium channel blocker may have an additive antihypertensive effect, a favorable effect on the metabolic profile, and an increased target organ damage protection. The new oral fixed combination manidipine 10 mg/delapril 30 mg has a greater antihypertensive effect than both components of the combination separately, and in non-responders to monotherapy with manidipine or delapril the average reduction of systolic and diastolic BP is 16/10 mmHg. The combination is well tolerated and the observed adverse effects are of the same nature as those observed in patients treated with the components as monotherapy. However, combination therapy reduces the incidence of Ankle Edema in patients treated with manidipine.Keywords: manidipine, delapril, manidipine–delapril combination, hypertensio
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Manidipine–delapril combination in the management of hypertension
Vascular health and risk management, 2007Co-Authors: Manuel Luque OteroAbstract:High blood pressure (BP) is the major cardiovascular risk factor and the main cause of death around the world. Control of blood pressure reduces the high mortality associated with hypertension and the most recent guidelines recommend reducing arterial BP values below 140/90 mmHg for all hypertensive patients (130/80 in diabetics) as a necessary step to reduce global cardiovascular risk, which is the fundamental objective of the treatment. To achieve these target BP goals frequently requires combination therapy with two or more antihypertensive agents. Although the combination of a diuretic and an angiotensin converting enzyme inhibitor (ACEI) is the most commonly used in the clinical practice, the combination of an ACEI and a calcium channel blocker may have an additive antihypertensive effect, a favorable effect on the metabolic profile, and an increased target organ damage protection. The new oral fixed combination manidipine 10 mg/delapril 30 mg has a greater antihypertensive effect than both components of the combination separately, and in non-responders to monotherapy with manidipine or delapril the average reduction of systolic and diastolic BP is 16/10 mmHg. The combination is well tolerated and the observed adverse effects are of the same nature as those observed in patients treated with the components as monotherapy. However, combination therapy reduces the incidence of Ankle Edema in patients treated with manidipine.
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manidipine delapril combination in the management of hypertension
Vascular Health and Risk Management, 2007Co-Authors: Manuel Luque OteroAbstract:High blood pressure (BP) is the major cardiovascular risk factor and the main cause of death around the world. Control of blood pressure reduces the high mortality associated with hypertension and the most recent guidelines recommend reducing arterial BP values below 140/90 mmHg for all hypertensive patients (130/80 in diabetics) as a necessary step to reduce global cardiovascular risk, which is the fundamental objective of the treatment. To achieve these target BP goals frequently requires combination therapy with two or more antihypertensive agents. Although the combination of a diuretic and an angiotensin converting enzyme inhibitor (ACEI) is the most commonly used in the clinical practice, the combination of an ACEI and a calcium channel blocker may have an additive antihypertensive effect, a favorable effect on the metabolic profile, and an increased target organ damage protection. The new oral fixed combination manidipine 10 mg/delapril 30 mg has a greater antihypertensive effect than both components of the combination separately, and in non-responders to monotherapy with manidipine or delapril the average reduction of systolic and diastolic BP is 16/10 mmHg. The combination is well tolerated and the observed adverse effects are of the same nature as those observed in patients treated with the components as monotherapy. However, combination therapy reduces the incidence of Ankle Edema in patients treated with manidipine.