open access

Vol 15, No 1 (2011)
Prace oryginalne
Published online: 2011-04-18
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Clinical effectiveness of a fixed-dose combination therapy with ramipril plus felodipine ER compared to monotherapy with ramipril or felodipine ER or to a fixed-dose combination therapy with verapamil SR and trandolapril or amlodipine and valsartan in treatment of primary hypertension — systematic review

Krystyna Widecka, Paweł Kawalec, Joanna Lis, Maciej Ostrowski
Nadciśnienie tętnicze 2011;15(1):13-20.

open access

Vol 15, No 1 (2011)
Prace oryginalne
Published online: 2011-04-18

Abstract


Background Beta-blockers, diuretics, calcium antagonists, angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor antagonists are commonly used as a first-line therapy in arterial hypertension monotherapy. But the majority of patients (70–80%) to sufficiently control their blood pressure require treatment with more than one antihypertensive agent. Calcium channel blockers (e.g. felodipine) are recommended as a first-line antihypertensive treatment. Combined use of ACE-I and calcium channel blocker may result in a good therapeutic effect given a complementary mode of action of the two agents. The aim of the study was to assess clinical effectiveness measured by clinical efficacy and safety of a fixed--dose combination therapy with ramipril plus felodipine ER compared with monotherapy with ramipril or felodipine ER or with a fixed-dose combination therapy with verapamil SR and trandolapril or amlodipine and valsartan as treatment options of primary hypertension.
Material and methods Clinical assessment was performed according to PolAHTA Guidelines; analysis and credibility evaluation were based on evidence-based medicine. In order to find the most relevant clinical publications a systematic review of medical databases was performed.
Results Systematic review revealed 7 reference publications of clinical trials which were used in specific analyses. It was shown that a fixed-dose combination of ramipril and felodipine ER is more efficient than monotherapy with ramipril or felodipine ER. It was also shown that the fixed- -dose combination of ramipril and felodipine ER was as efficient as other fixed-dose combinations (verapamil SR and trandolapril or amlodipine and valsartan). Apart from that it was demonstrated that the safety profile of the fixed- -dose combination of ramipril and felodipine ER was good and similar to the one of other antihypertensive fixed-dose combinations.
Arterial Hypertension 2011, vol. 15, no 1, pages 13–20

Abstract


Background Beta-blockers, diuretics, calcium antagonists, angiotensin converting enzyme inhibitors (ACE-I) and angiotensin receptor antagonists are commonly used as a first-line therapy in arterial hypertension monotherapy. But the majority of patients (70–80%) to sufficiently control their blood pressure require treatment with more than one antihypertensive agent. Calcium channel blockers (e.g. felodipine) are recommended as a first-line antihypertensive treatment. Combined use of ACE-I and calcium channel blocker may result in a good therapeutic effect given a complementary mode of action of the two agents. The aim of the study was to assess clinical effectiveness measured by clinical efficacy and safety of a fixed--dose combination therapy with ramipril plus felodipine ER compared with monotherapy with ramipril or felodipine ER or with a fixed-dose combination therapy with verapamil SR and trandolapril or amlodipine and valsartan as treatment options of primary hypertension.
Material and methods Clinical assessment was performed according to PolAHTA Guidelines; analysis and credibility evaluation were based on evidence-based medicine. In order to find the most relevant clinical publications a systematic review of medical databases was performed.
Results Systematic review revealed 7 reference publications of clinical trials which were used in specific analyses. It was shown that a fixed-dose combination of ramipril and felodipine ER is more efficient than monotherapy with ramipril or felodipine ER. It was also shown that the fixed- -dose combination of ramipril and felodipine ER was as efficient as other fixed-dose combinations (verapamil SR and trandolapril or amlodipine and valsartan). Apart from that it was demonstrated that the safety profile of the fixed- -dose combination of ramipril and felodipine ER was good and similar to the one of other antihypertensive fixed-dose combinations.
Arterial Hypertension 2011, vol. 15, no 1, pages 13–20
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Keywords

blood hypertension; calcium channel blocker; angiotensin converting enzyme inhibitors; monotherapy; combined therapy

About this article
Title

Clinical effectiveness of a fixed-dose combination therapy with ramipril plus felodipine ER compared to monotherapy with ramipril or felodipine ER or to a fixed-dose combination therapy with verapamil SR and trandolapril or amlodipine and valsartan in treatment of primary hypertension — systematic review

Journal

Arterial Hypertension

Issue

Vol 15, No 1 (2011)

Pages

13-20

Published online

2011-04-18

Bibliographic record

Nadciśnienie tętnicze 2011;15(1):13-20.

Keywords

blood hypertension
calcium channel blocker
angiotensin converting enzyme inhibitors
monotherapy
combined therapy

Authors

Krystyna Widecka
Paweł Kawalec
Joanna Lis
Maciej Ostrowski

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