Open AccessEfficacy of Combination Therapy for Systolic Blood Pressure in Patients With Severe Systolic Hypertension: The Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) Study
Author(s) -
Neutel Joel M.,
Smith David H.G.,
Weber Michael A.,
Schofield Lesley,
Purkayastha Das,
Gatlin Marjorie
Publication year - 2005
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1524-6175.2005.04615.x
Subject(s) - medicine , blood pressure , amlodipine , benazepril , ambulatory blood pressure , systolic hypertension , pulse pressure , combination therapy , cardiology , diastole , isolated systolic hypertension , peripheral edema , prehypertension , adverse effect
Systolic hypertension is predominant among patients over 50 years of age, is a more important cardiovascular risk factor than diastolic blood pressure, and is more difficult to control than diastolic blood pressure. Consequently, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) recommends combination therapy as first‐line treatment for patients with stage 2 hypertension. In the Systolic Evaluation of Lotrel Efficacy and Comparative Therapies (SELECT) study, 24‐hour ambulatory blood pressure monitoring was used to identify patients with systolic hypertension and to determine the impact of 8 weeks of treatment with either amlodipine besylate/benazepril HCl 5/20 mg combination therapy (n=149), amlodipine besylate 5 mg (n=146), or benazepril HCl 20 mg (n=148). Combination therapy was significantly more effective in reducing systolic blood pressure and pulse pressure than either monotherapy ( p <0.0001). Significantly greater percentages of patients in the combination group compared with either monotherapy achieved blood pressure control ( p <0.0001). Adverse events were low in all three treatment arms, with less peripheral edema in the combination group than in the amlodipine‐treated group. The combination of amlodipine besylate/benazepril HCl given to patients with stage 2 systolic hypertension resulted in significantly greater reductions in blood pressure and pulse pressure than those seen with monotherapy and was at least as well tolerated as the separate components. This data supports the recommendation of the JNC 7 for the use of combination therapy in patients with stage 2 hypertension.