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“Introduction Blood pressure (BP) control rates are improving but are still far from adequate. The latest report stated that BP control has improved considerably from 25% to 50% at present.[1] Although these control rates may be true for the recommended BP goals of <140/90 mmHg for uncomplicated hypertension, the control rates for the more aggressive goal of <130/80 mmHg for persons with diabetes mellitus, chronic renal disease, or coronary heart disease (CHD) are lower.[2–5] click here Most studies show that in order to reach these goals, the majority of patients will require two or more
antihypertensive drugs.[6–10] Calcium-channel blockers (CCBs) and angiotensin-converting enzyme (ACE) inhibitors are still recommended for first-line therapy for hypertension,[2,3] but given alone, do not produce BP reductions to currently recommended BP goals, and in most patients with stage 2 hypertension, a combination of two drugs from different classes is recommended.[2–4] The combination of a CCB with an ACE inhibitor is particularly attractive for patients with diabetes or hyperlipidemia because both drugs are metabolically
neutral. In addition, the combination of an ACE inhibitor with amlodipine, a dihydropyridine CCB, will increase the latter’s antihypertensive effect[11–14] and ameliorate the incidence and magnitude of pedal edema.[11,12] The currently available fixed-dose combination of amlodipine/benazepril 5/10 and 10/20 mg/day has been effective in reducing BP, but more aggressive treatment of hypertension with higher-dose combinations may be necessary to bring BP to goal, especially in populations like Black patients, who are resistant to treatment.[13] Several clinical trials have shown that the combination of ACE inhibitors or angiotensin-receptor blockers (ARBs) with a CCB is synergistic and provides Avelestat (AZD9668) greater reductions of BP in a variety of hypertensive populations, and the vasodilatory edema seen with the dihydropyridine CCBs is usually decreased with their combination.[11,12,15–18] In this report, we present the effectiveness and safety of a high-dose combination of benazepril with amlodipine in Black and White hypertensive patients compared with high-dose monotherapy with benazepril hydrochloride 40 mg/day or amlodipine besylate 10 mg/day. Subjects and Methods Study H2303 consisted of 291 completed subjects and study H2304 consisted of 763 completed subjects. All subjects were well matched for age and sex and other clinical parameters.