Amlodipine-Valsartan Combination Decreases Central Systolic Blood Pressure More Effectively Than the Amlodipine-Atenolol Combination The EXPLOR Study
Amlodipine-Valsartan Combination Decreases Central Systolic Blood Pressure More Effectively Than the Amlodipine-Atenolol Combination The EXPLOR Study
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DOI：
10.1161/hypertensionaha.109.148999
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发表时间：
2010-06-01
期刊：
影响因子：
8.3
通讯作者：
Laurent, Stephane
中科院分区：
文献类型：
--
作者：
Boutouyrie, Pierre;Achouba, Assya;Laurent, Stephane
β-受体阻滞剂阿替洛尔在降低中心血压(BP)方面不如血管紧张素受体阻滞剂和钙通道阻滞剂有效。这项试验旨在确定当血管紧张素受体阻滞剂和钙通道阻滞剂氨氯地平联合应用时，血管紧张素受体阻滞剂相对于阿替洛尔的优势是否仍然显著。采用前瞻性、随机化、盲法终点(探针设计)平行分组多中心试验，纳入393例耐氨氯地平4周的高血压病患者。分别于入选时、氨氯地平-缬沙坦联合用药(5/80 mg后10/160 mg)或氨氯地平-阿替洛尔联合用药(5/50 mg后10/100 mg)治疗8周和24周后，用平坦式眼压计(SPhygmoCor)测量中心收缩压、增强指数(AIX)和颈动脉-股动脉脉搏波速度。从基线到24周，氨氯地平-缬沙坦组中心收缩压下降幅度更大(-13.70+/-1.15 mm Hg；P
The beta-blocker atenolol is less effective than angiotensin-receptor blockers and calcium-channel blockers for reducing central blood pressure (BP). The trial was designed to determine whether the advantages of angiotensin-receptor blockers over atenolol remained significant when both were combined with the calcium-channel blocker amlodipine. A prospective, randomized, blinded endpoint (PROBE design) parallel group, multicenter trial including 393 patients with essential hypertension resistant to 4 weeks of 5 mg of amlodipine was set out. Central systolic BP, augmentation index (AIx; either rough or adjusted on heart rate), and carotid-to-femoral pulse wave velocity were measured with applanation tonometry (SphygmoCor) at inclusion and after 8 and 24 weeks of active treatment with an amlodipine-valsartan combination (5/80 mg and then 10/160 mg) or an amlodipine-atenolol combination (5/50 mg and then 10/100 mg). From baseline to week 24, central systolic BP decreased significantly more in the amlodipine-valsartan group (-13.70 +/- 1.15 mm Hg; P