Systolic Hypertension in Elderly
Candesartan Plus Felodipine Effective in Elderly With Systolic Hypertension
NEW YORK (Reuters Health) Jun 27 - Compared with monotherapy with either candesartan or felodipine, combination therapy with both drugs results in significant blood pressure reductions among elderly patients with systolic hypertension.
In a randomized crossover trial, Dr. Trefor Morgan from the University of Melbourne, Parkville and Dr. Adrianne Anderson from Austin and Repatriation Hospital Medical Center, Heidelberg, both in Australia, studied 31 patients, over 65 years of age, with systolic hypertension.
The patients completed four 1-month treatment periods during which they received candesartan 16 mg/day, felodipine 5 mg/day, both drugs, or placebo, according to a report in the June issue of the American Journal of Hypertension.
Compared with placebo, monotherapy with either candesartan or felodipine reduced mean 24-hour systolic blood pressure by similar amounts (candesartan by 12.2 mm Hg, felodipine by 11.9 mm Hg). The combination of both drugs reduced mean 24 hour systolic blood pressure by a significant 21.0 mm Hg compared with placebo (p<0.005), the researchers found.
Despite previous blood pressure treatment, 12 of the patients had microalbuminuria or proteinuria at baseline. Candesartan and combination therapy, but not felodipine monotherapy, reduced urinary albumin excretion in these patients, according to the report.
There were few side effects from either candesartan or felodipine and fewer still with combination treatment, Drs. Morgan and Anderson note.
"This combination is suitable for use in persons with systolic hypertension who do not achieve control with either drug as monotherapy," they conclude.
Am J Hypertens 2002;15:544-549.