Differential Effects of Aliskiren/Amlodipine Combination and High-Dose Amlodipine Monotherapy on Endothelial Function in Elderly Hypertensive Patients

作者：Fukutomi Motoki; Hoshide Satoshi; Mizuno Hiroyuki; Kario Kazuomi^*

来源：American Journal of Hypertension, 2014, 27(1): 14-20.

DOI：10.1093/ajh/hpt158

• ambulatory blood pressure
• blood pressure
• calcium channel blocker
• direct renin inhibitor
• endothelial function
• hypertension

BACKGROUND The aim of this study was to compare the effects of direct renin inhibitor, aliskiren, and amlodipine combination therapy with those of high-dose amlodipine monotherapy on endothelial function in elderly hypertensive patients. %26lt;br%26gt;METHODS Participants included 105 patients (mean age 77 years) who had receive 5mg amlodipine for 4 weeks. Patients were allocated to the aliskiren/amlodipine group (AL/AM) or the high-dose amlodipine (AM) group. The AL/AM group received 150mg aliskiren in addition to 5mg amlodipine for 8 weeks; then the dose of aliskiren was doubled to 300mg for another 8 weeks. The AM group received 10mg amlodipine for 16 weeks. Of the 105 patients, 87 who underwent measurements of brachial flow-mediated vasodilation (FMD) and nitroglycerin-mediated vasodilation (NMD) before and after the study were included in the analysis. %26lt;br%26gt;RESULTS Blood pressurelowering effects were similar in the 2 groups. Plasma renin activity significantly decreased in the AL/AM group (P %26lt; 0.001) but increased in the AM group (P %26lt; 0.001). Improvement of FMD was found in the AL/AM group (2.6% to 3.7%, P 0.001) but not in the AM group, while NMD did not change in either group. The changes in 24-hour systolic blood pressure (r 0.60, P %26lt; 0.001) and diastolic blood pressure (r 0.46, P 0.004) were significantly correlated with improvement of FMD in the AL/AM group but not in the AM group. %26lt;br%26gt;CONCLUSION Addition of aliskiren improved endothelial function in elderly hypertensive patients treated with amlodipine.

• 出版日期2014-1