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

被引：5

作者：

Imaizumi, Satoshi ^{[1
,2
]}

Shiga, Yuhei ^{[1
]}

Ogawa, Masahiro ^{[1
]}

Sako, Hideto ^{[1
]}

Nagata, Yoshihisa ^{[1
]}

Matsunaga, Akira ^{[3
]}

Shirotani, Tetsuro ^{[4
]}

Hoshino, Fumihiro ^{[5
]}

Yahiro, Eiji ^{[6
]}

Uehara, Yuko ^{[7
]}

Morito, Natsumi ^{[1
]}

Tanigawa, Hiroyuki ^{[8
]}

Shimono, Dai ^{[9
]}

Fukushima, Mikio ^{[10
]}

Sugihara, Hidekazu ^{[11
]}

Norimatsu, Kenji ^{[12
]}

Kusumoto, Takaaki ^{[12
]}

Saku, Keijiro ^{[1
,13
]}

Miura, Shin-Ichiro ^{[1
,13
]}

Ideishi, Munehito

Iwata, Atsushi

Noda, Keita

Fujimi, Kanta

Kawamura, Akira

Adachi, Sen

Nishikawa, Hiroaki

Fukushima, Takao

Tanaka, Nobuhide

Fujisawa, Kazuhiro

Takamiya, Yosuke

Arishima, Hiroaki

Shimokawa, Toshihiro

Seto, Hiroshi

Inoue, Asao

Midorikawa, Takemasa

Shijo, Hiroshi

机构：

[1] Fukuoka Univ, Sch Med, Dept Cardiol, Fukuoka, Fukuoka, Japan

[2] Fukuoka Univ, Sch Med, Clin Res & Eth Ctr, Fukuoka, Fukuoka, Japan

[3] Fukuoka Univ, Sch Med, Dept Lab Med, Fukuoka, Fukuoka, Japan

[4] Shirotani Hosp, Fukuoka, Fukuoka, Japan

[5] Murakami Karindoh Hosp, Fukuoka, Fukuoka, Japan

[6] Fukuoka Univ, Sch Med, Med Educ Ctr, Fukuoka, Fukuoka, Japan

[7] Showa Hosp, Fukuoka, Fukuoka, Japan

[8] Tanigawa Hosp, Nagasaki, Japan

[9] Futata Tetsuhiro Clin, Fukuoka, Fukuoka, Japan

[10] Fukushima Hosp, Oita, Japan

[11] Fukuseikai Hosp, Fukuoka, Fukuoka, Japan

[12] Izumi Gen Med Ctr, Kagoshima, Japan

[13] Fukuoka Univ, Sch Med, Dept Mol Cardiovasc Therapeut, Fukuoka, Fukuoka, Japan

来源：

HEART AND VESSELS | 2019年 / 34卷 / 04期

关键词：

Angiotensin II type 1 receptor blocker; Calcium channel blocker; Essential Hypertension; Home blood pressure; Type 2 diabetes mellitus; BLOOD-PRESSURE CONTROL; CARDIOVASCULAR RISK; AMLODIPINE; OUTCOMES; ADIPONECTIN; SYSTEM; OLMESARTAN; MANAGEMENT; IRBESARTAN; VALSARTAN;

D O I：

10.1007/s00380-018-1286-2

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 (5mg/day) and ARB, were enrolled. Participants were randomized to receive either a high dose of amlodipine (10mg/day) plus a medium dose of ARB (high-AML) or a medium dose of amlodipine (5mg/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; -7.9mmHg vs. +2.7mmHg; p=0.0002, diastolic BP; -3.9mmHg vs. +0.6mmHg; 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.

引用

页码：698 / 710

页数：13

共 39 条

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