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Effect of antihypertensive monotherapy and combination therapy on arterial distensibility and left ventricular mass

Joel M Neutel1, David H G Smith, Michael A Weber

  • 1Orange County Heart Institute and Research Center, Orange, California, USA.

American Journal of Hypertension
|January 1, 2004
PubMed

Insights

Combined therapy with ACE inhibitors and calcium channel blockers significantly improved arterial compliance and reduced left ventricular mass more effectively than high-dose monotherapy in hypertensive patients.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Hypertension management often involves Angiotensin-Converting Enzyme (ACE) inhibitors and Calcium Channel Blockers (CCBs).
  • Both drug classes demonstrate benefits in improving arterial compliance and reducing left ventricular mass.
  • Investigating combination therapy versus escalated monotherapy is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To compare the efficacy of combined ACE inhibitor and CCB therapy against maximized doses of monotherapy.
  • To assess the impact on arterial distensibility and left ventricular mass in hypertensive patients.

Main Methods:

  • A prospective, randomized, open-label study involving 106 patients with mild-to-moderate hypertension.
  • Patients received initial low-dose amlodipine or benazepril, followed by force-titration to higher monotherapy doses or combination therapy.
  • Arterial distensibility and left ventricular mass were measured using the DynaPulse system and echocardiography, respectively.

Main Results:

  • Combination therapy significantly enhanced arterial distensibility compared to either amlodipine or benazepril monotherapy.
  • Left ventricular mass reduction was greater with combination treatment than with amlodipine monotherapy.
  • While left ventricular mass decreased with benazepril, the difference from combination therapy was not statistically significant.

Conclusions:

  • Combined ACE inhibitor and CCB treatment offers superior efficacy in improving arterial compliance and reducing left ventricular mass compared to high-dose monotherapy.
  • These findings suggest that strategic combination therapy may provide enhanced cardioprotective effects in managing hypertension.
Abstract

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