Display options
Share it on

Exp Clin Cardiol. 2007;12(1):33-6.

Beneficial effect of combination therapy with antihypertensive drugs in patients with hypertension.

Experimental and clinical cardiology

Chihiro Shikata, Tetsuaki Sekikawa, Nobuaki Kimura, Akira Kojima, Shingo Seki, Hisayoshi Oka, Akihiro Nishiyama, Nobuakira Takeda

Affiliations

  1. Department of Internal Medicine, Aoto Hospital, Jikei University School of Medicine.

PMID: 18650977 PMCID: PMC2359624

Abstract

BACKGROUND: Cardiac hypertrophy and failure are major complications of hypertension.

OBJECTIVES: The beneficial effect of treatment with antihypertensive drugs on serum levels of brain natriuretic peptide (BNP) was examined in patients with essential hypertension.

METHODS: Antihypertensive drugs were administered to 88 hypertensive patients (44 diabetic and 44 nondiabetic) whose systolic blood pressure was greater than 140 mmHg and/or diastolic blood pressure was greater than 90 mmHg. Other antihypertensive drugs were added every two months until the blood pressure fell below 130/85 mmHg. Candesartan, benidipine, bisoprolol or celiprolol, and bunazosin were administered in this order.

RESULTS: The mean systolic blood pressure was reduced from 163.7+/-11.6 mmHg to 121.8+/-7.5 mmHg after 12 months in patients with diabetes and from 167.6+/-12.3 mmHg to 122.8+/-7.5 mmHg in patients without diabetes. The mean diastolic blood pressure was also significantly reduced in patients with and without diabetes. Serum BNP levels were reduced from 52.2+/-38.8 pg/mL to 38.8+/-30.9 pg/mL in patients with diabetes and from 47.1+/-34.2 pg/mL to 35.8+/-22.5 pg/mL in patients without diabetes. In patients older than 70 years of age, serum BNP levels were reduced from 56.3+/-39.3 pg/mL to 40.2+/-23.0 pg/mL in those with diabetes and from 54.6+/-32.9 pg/mL to 38.0+/-16.0 pg/mL in those without diabetes.

CONCLUSIONS: These results indicate that combination therapy with antihypertensive drugs is usually necessary to reduce blood pressure to below 130/85 mmHg and to improve serum BNP levels.

Keywords: Angiotensin II receptor blocker; Brain natriuretic peptide; Calcium antagonist; Combination therapy; Hypertension

References

  1. Circulation. 2000 Oct 10;102(15):1802-6 - PubMed
  2. Curr Control Trials Cardiovasc Med. 2002 Nov 14;3(1):10 - PubMed
  3. J Cardiol. 2002 Apr;39(4):195-204 - PubMed
  4. JAMA. 2002 Dec 18;288(23):2981-97 - PubMed
  5. Clin Ther. 1989 Sep-Oct;11(5):568-71 - PubMed
  6. J Hum Hypertens. 1999 Jan;13 Suppl 1:S71-4 - PubMed
  7. Nature. 1988 Mar 3;332(6159):78-81 - PubMed
  8. Blood Press. 1998 May;7(3):170-5 - PubMed
  9. J Clin Invest. 1991 Apr;87(4):1402-12 - PubMed
  10. J Hypertens. 1996 Dec;14(12):1469-75 - PubMed
  11. Blood Press Suppl. 2000;1:36-9 - PubMed
  12. Lancet. 1997 Sep 13;350(9080):757-64 - PubMed
  13. J Renin Angiotensin Aldosterone Syst. 2000 Sep;1 Suppl 1:31-6 - PubMed
  14. Metabolism. 2004 Jun;53(6):777-81 - PubMed
  15. JAMA. 1991 Jun 26;265(24):3255-64 - PubMed
  16. J Cardiovasc Pharmacol. 1998 Jan;31(1):140-5 - PubMed
  17. Lancet. 1991 Nov 23;338(8778):1281-5 - PubMed
  18. Basic Res Cardiol. 1991;86 Suppl 1:113-30 - PubMed
  19. Lancet. 1997 Nov 8;350(9088):1349-53 - PubMed
  20. Cardiovasc Drugs Ther. 1998 Oct;12(5):469-74 - PubMed
  21. Am J Hypertens. 2001 May;14(5 Pt 2):12S-16S - PubMed
  22. Hypertens Res. 2000 Nov;23(6):601-5 - PubMed
  23. J Hypertens. 1999 Feb;17(2):151-83 - PubMed
  24. Am J Hypertens. 2000 Sep;13(9):1045-8 - PubMed
  25. JAMA. 1997 Mar 5;277(9):739-45 - PubMed
  26. Lancet. 1990 Apr 7;335(8693):827-38 - PubMed
  27. Lancet. 1999 Jan 2;353(9146):9-13 - PubMed
  28. Can J Cardiol. 1987 May;3(4):183-96 - PubMed
  29. Circulation. 1997 Jul 15;96(2):509-16 - PubMed
  30. Blood Press. 2001;10(2):101-10 - PubMed
  31. N Engl J Med. 2002 Jul 18;347(3):161-7 - PubMed
  32. Circulation. 1997 Oct 7;96(7):2197-205 - PubMed
  33. Mol Cell Biochem. 2003 Jun;248(1-2):197-202 - PubMed
  34. J Am Coll Cardiol. 1996 Apr;27(5):1214-8 - PubMed

Publication Types