Revista argentina de cardiología
versión On-line ISSN 1850-3748
BRANDANI, Laura M. J. et al. Combination of a Converting Enzyme Inhibitor (ACEI) with a Calcium Antagonist versus Monotherapy with an ACEI: Therapeutic Efficacy in Essential Hypertension and Regression of Ventricular Hypertrophy. Rev. argent. cardiol. [online]. 2006, vol.74, n.4, pp. 198-203. ISSN 1850-3748.
Objective To evaluate the effectiveness, tolerability and effect on the regression of left ventricular hypertrophy, of a combination therapy of amlodipine and benazepril (B+A), versus monotherapy with benazepril (B). Methods We included 33 patients (p) with essential hypertension. During 6 months of treatment, 18 p received B+A (9 men, 55±2 years) and 15 received B (10 men, 49±2 years). An ambulatory blood pressure monitoring (ABPM) was performed at the beginning and at 3 and 6 months of therapy. In a subgroup of 23 patients, left ventricular mass (LVM) and LVM index (LVMI) were calculated from the two dimensional echocardiogram, at the beginning and the end of treatment. Results At 3 months of treatment, blood pressure (BP) values were significantly (p<0.05) lower in patients receiving B+A (24h: 123±1.7/77±1.8 mmHg; Day time: 127±1.9/ 81±1.8 mmHg; Night time: 115±2.0/68±2.1) compared to p treated only with B (24hs: 132±1.5/ 85±1.6 mmHg; Day time: 137±1.8/ 91±1.9mmHg and Night time: 122±2.0/ 76±1.7 mmHg). This was achieved with lower doses of B+A and better tolerability than with B. In the B+A group, LVM and LVMI decreased significantly from 225.3±47.4g and 125.5±19.3g/m2, to 187.2±45.1g and 104.7±27.2g/m2, respectively (p<0.05), while in group B, the decreases was not statistically significant. At the end of treatment, only patients treated with B+A showed a significant and positive correlation between the drop in SBP and LVM (LVM: r=056, p<0.025) and LVMI (LVMI: r=060, p<0.01). Conclusions The combination of B+A elicited a more rapid reduction in BP, with a lower dose and better clinical tolerance than B. Additionally, only the combined therapy with B+A was effective to decrease LVM and LVMI.
Palabras clave : Left ventricular hypertrophy; Pharmacotherapy; Drugs combination; Therapeutic efficacy.