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Phase III Randomized Clinical Trial of Efficacy and Safety of Amlodipine and Candesartan Cilexetil Combination for Hypertension Treatment

Abstract

Effective antihypertensive therapy is essential for achieving optimal blood pressure (BP) control and reducing cardiovascular events. This double-blind, multicenter, randomized trial aimed to compare the antihypertensive efficacy and safety of a combination of amlodipine (AML) and candesartan cilexetil (CC) versus AML monotherapy in patients with essential hypertension (HTN). After a 4-week run-in period with AML 5 mg, patients whose HTN remained uncontrolled (diastolic BP [DBP]) ≥ 90 mmHg and < 120 mmHg) were randomized to receive either AML + CC or AML alone for 8 weeks. Efficacy was assessed by measuring changes in DBP and systolic BP (SBP). The primary safety measure was the incidence of adverse events (AEs). A total of 174 participants were included in the efficacy analysis. After 8 weeks, DBP decreased by -9.92 ± 0.86 mmHg in the AML + CC arm and - 2.08 ± 0.86 mmHg in the AML arm (p < 0.0001). SBP decreased by -14.27 ± 1.39 mmHg in the AML + CC arm versus - 2.77 ± 1.39 mmHg in the AML arm (p < 0.0001). AEs occurred in 11.24% of the AML + CC group and 5.62% of the AML group (p = 0.1773). AML + CC combination therapy demonstrated superior efficacy with good tolerance, making it a promising option for patients with inadequately controlled hypertension on amlodipine alone.

References
1.
Li N, Lee A, Whitmer R, Kivipelto M, Lawler E, Kazis L . Use of angiotensin receptor blockers and risk of dementia in a predominantly male population: prospective cohort analysis. BMJ. 2010; 340:b5465. PMC: 2806632. DOI: 10.1136/bmj.b5465. View

2.
Kang S, Youn J, Chae S, Park C, Yang J, Kim M . Comparative efficacy and safety profile of amlodipine 5 mg/losartan 50 mg fixed-dose combination and amlodipine 10 mg monotherapy in hypertensive patients who respond poorly to amlodipine 5 mg monotherapy: an 8-week, multicenter, randomized,.... Clin Ther. 2011; 33(12):1953-63. DOI: 10.1016/j.clinthera.2011.11.007. View

3.
Vanderheyden P, Fierens F, Vauquelin G . Angiotensin II type 1 receptor antagonists. Why do some of them produce insurmountable inhibition?. Biochem Pharmacol. 2000; 60(11):1557-63. DOI: 10.1016/s0006-2952(00)00388-9. View

4.
Kim H, Lee H, Lee H, Lee G, Kim E, Song M . Korea hypertension fact sheet 2022: analysis of nationwide population-based data with a special focus on hypertension in the elderly. Clin Hypertens. 2023; 29(1):22. PMC: 10426053. DOI: 10.1186/s40885-023-00243-8. View

5.
Yasuno S, Fujimoto A, Nakagawa Y, Kuwahara K, Ueshima K . Fixed-dose combination therapy of candesartan cilexetil and amlodipine besilate for the treatment of hypertension in Japan. Expert Rev Cardiovasc Ther. 2012; 10(5):577-83. DOI: 10.1586/erc.12.34. View