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- Title
Randomized trial of an increased dose of calcium channel blocker or angiotensin II type 1 receptor blocker as an add-on intensive depressor therapy in type 2 diabetes mellitus patients with uncontrolled essential hypertension: the ACADEMIE Study.
- Authors
Imaizumi, Satoshi; Shiga, Yuhei; Ogawa, Masahiro; Sako, Hideto; Nagata, Yoshihisa; Matsunaga, Akira; Shirotani, Tetsuro; Hoshino, Fumihiro; Yahiro, Eiji; Uehara, Yuko; Morito, Natsumi; Tanigawa, Hiroyuki; Shimono, Dai; Fukushima, Mikio; Sugihara, Hidekazu; Norimatsu, Kenji; Kusumoto, Takaaki; Saku, Keijiro; Miura, Shin-ichiro
- Abstract
There is a lack of data on how to treat hypertensive patients with diabetes when treatment with medium doses of calcium channel blocker and angiotensin II type 1 receptor blocker (ARB) is insufficient to achieve the target blood pressure (BP). A total of 121 participants with type 2 diabetes and uncontrolled essential hypertension, who were receiving medium doses of amlodipine (5 mg/day) and ARB, were enrolled. Participants were randomized to receive either a high dose of amlodipine (10 mg/day) plus a medium dose of ARB (high-AML) or a medium dose of amlodipine (5 mg/day) plus a high dose of ARB (high-ARB). The depressor effects of these two regimens were monitored using a telemonitoring home BP-measuring system. Fifty-four patients were excluded after an observation period, and the remaining 67 eligible participants were randomized into the two groups; 42 which had a record of their home BP for analysis. The change in morning home systolic and diastolic BP was greater in the high-AML than in the high-ARB (systolic BP; − 7.9 mmHg vs. + 2.7 mmHg; p = 0.0002, diastolic BP; − 3.9 mmHg vs. + 0.6 mmHg; p = 0.0007). In addition, the home systolic and diastolic BP before going to bed and office systolic BP were significantly reduced from week 0 only in the high-AML. An increased dose of amlodipine, but not ARB, reduced home morning BP in hypertensive patients with type 2 diabetes who were already receiving combination therapy with medium doses of amlodipine and ARB.
- Subjects
TYPE 2 diabetes; CALCIUM antagonists; ANGIOTENSIN II; ESSENTIAL hypertension; PEOPLE with diabetes
- Publication
Heart & Vessels, 2019, Vol 34, Issue 4, p698
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-018-1286-2