antihypertensive efficacy of fixed combination drug

Conditions: Hypertension

Summary: treatment and control of hypertension is still insufficient. about 50% of the patients remain uncontrolled. lack of compliance with discontinuation of drug treatment is an important reason for not achieving blood pressure. several studies have shown that use of fixed combinations improve compliance significantly, by reducing the number of pill's intake. this study will assess the antihypertensive efficacy of vasodip-combo 20® \[enalapril 20 mg + lercanidipine 10 mg\] as a fixed combination drug in uncontrolled antihypertensive patients.

this is a single centre observational uncontrolled prospective study, hypertensive patients that are either treatment naïve or uncontrolled on current therapy \[one or two drugs\] and meet all inclusion and exclusion criteria, will be assigned to vasodip-combo 20 as unique drug treatment. the treatment will then be continued for additional 4 weeks. office blood pressure will be performed by the physician at each visit. 24 h. ambulatory blood pressure measurements \[abpm\] and blood samples for electrolytes, creatinine and urea will be taken at base line visit and at at week 4. efficacy will be defined in terms of therapeutic goals expressed as target blood pressures according to world health organization and european society of hypertension \[ for office blood pressure and ambulatory blood pressure measurements\] criteria: office blood pressure: diastolic blood pressure ≤ 90 mmhg and systolic blood pressure ≤ 140 mmhg for non-diabetics or diastolic blood pressure ≤ 80 mmhg and systolic blood pressure ≤ 130 mmhg for diabetics, respectively. 24 h ambulatory blood pressure measurements: 224 hour: diastolic blood pressure≤ 80 mmhg and systolic blood pressure ≤ 130 mmhg, awake time: diastolic blood pressure ≤ 85 mmhg,systolic blood pressure ≤ 135 mmhg asleep time: diastolic blood pressure ≤70 mmhg, systolic blood pressure ≤ 70 mmhg. effectiveness and safety will also be evaluated taking into consideration patient compliance safety assessments: safety will be assessed by means of (s)adverse effects reporting.

Eligibility criteria:
inclusion criteria: 1. essential hypertension at visit 1 defined as office blood pressure \ 130/80 mmhg with a day time blood pressure (extracted from the 24h abpm) \>135/85 mmhg 2. male and female 3. age 18-80 4. every patient that in the medical opinion of the treating physician is eligible for vasodip combo 20 treatment. 5. willing to sign an informed consent exclusion criteria: 1. use of more than 2 anti hypertensive medication at visit 1 (fixed combination is considered as two drugs) 2. mean 24 h abpm values of more than 180/100 mmhg 3. pregnant women 4. women with potential age of pregnancy. 5. suspected secondary hypertension (investigator decision) 6. uncontrolled diabetes mellitus(investigator decision) 7. any of the following in the last six months: myocardial infarction, stroke, coronary by-pass surgery, percutaneous coronariography with balloon dilation and/or stent insertion 8. congestive heart failure requiring pharmacological treatment 9. renal failure, defined as serum creatinine equal or great than 1.5 mg% \[confirmed twice\] or hyperkalemia defined as serum potassium equal or great that 5 meq/l \[confirmed twice\] 10. malignancy that required chemotherapy in the last 3 years. 11. any medical or none medical condition that in the eyes of the investigator will not allow the patient to complete the study.

Keywords: hypertension fixed combination lercanidipine enalapril blood pressure monitoring, ambulatory