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document
Effects of monotherapy and combination therapy on blood pressure control and target organ damage : a randomized prospective intervention study in a large population of hypertensive patients . This prospective , randomized trial evaluated the effect of monotherapy and different combination therapies on cardiovascular target organ damage and metabolic profile in 520 hypertensive patients . Patients were allocated to a single agent : carvedilol 25 mg , amlodipine 10 mg , enalapril 20 mg , or losartan 50 mg ( groups C , A , E , and L , respectively ) . After 2 months ( level 2 ) , nonresponders received a low-dose thiazide diuretic , and after 4 months ( level 3 ) , amlodipine ( groups E , C , and L ) and carvedilol ( group A ) . Twenty-four-hour blood pressure was significantly lowered in all treatment groups . Blood pressure control was more pronounced in patients receiving two or three drugs . At the end of the study , the carotid intima-media thickness decreased in group L ( P < .01 ) , left ventricular mass index in groups E and L ( P < .05 and P < .001 , respectively ) , with a concomitant reduction in cholesterol in group L ( P < .03 ) . Diastolic function improved significantly in group L ( P < .05 ) . This study describes the need to control blood pressure with two or more drugs in most hypertensive patients and illustrates good clinical outcomes , independent of blood pressure lowering , using combination therapy with losartan , low-dose thiazide , and amlodipine .
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Intervention_Pharmacological
monotherapy and combination therapy
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Intervention_Pharmacological
monotherapy and different combination therapies
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Intervention_Pharmacological
carvedilol 25 mg , amlodipine 10 mg , enalapril 20 mg , or losartan 50 mg
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Intervention_Pharmacological
low-dose thiazide diuretic
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Intervention_Pharmacological
amlodipine
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Intervention_Pharmacological
carvedilol
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Intervention_Pharmacological
losartan
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Intervention_Pharmacological
low-dose thiazide
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Intervention_Pharmacological
amlodipine
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Outcome_Physical
Twenty-four-hour blood pressure
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Outcome_Physical
Blood pressure control
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Outcome_Physical
carotid intima-media thickness
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Outcome_Physical
left ventricular mass index
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Outcome_Physical
cholesterol
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Outcome_Physical
Diastolic function
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Outcome_Physical
blood pressure
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Participant_Sample-size
520
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Participant_Condition
hypertensive patients