Open AccessAmlodipine Added to Quinapril vs Quinapril Alone for the Treatment of Hypertension in Diabetes: The Amlodipine in Diabetes (ANDI) Trial
Author(s) -
Tobe Sheldon,
KaweckaJaszcz Kalina,
Zannad Faiez,
Vetrovec George,
Patni Rajiv,
Shi Harry
Publication year - 2007
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.1524-6175.2007.06949.x
Subject(s) - quinapril , amlodipine , medicine , diabetes mellitus , ace inhibitor , cardiology , endocrinology , angiotensin converting enzyme , blood pressure
This randomized, comparative, parallel‐group trial investigated strategies of blood pressure (BP)‐lowering in patients with diabetes and hypertension. Patients not reaching goal BP (<130/80 mm Hg) after 4‐week open‐label treatment with quinapril 20 mg/d (n=374) received 40 mg/d quinapril (n=167) or 20 mg/d quinapril plus amlodipine besylate (5 mg/d; n=162) for 6 weeks. Patients receiving combination therapy vs monotherapy had significantly greater reductions in mean ± SE sitting systolic BP (9.9±1.0 mm Hg vs 4.3±1.1 mm Hg; P<.001) and diastolic BP (6.5±0.6 mm Hg vs 2.7±0.6 mm Hg; P<.001). No significant differences between groups were observed in percentage of patients achieving goal BP (10.1% with combination therapy vs 8.2% with monotherapy). A clinically neutral effect was observed on high‐sensitivity C‐reactive protein in both groups. Treatments were well tolerated; fewer than 3% of patients in any group discontinued due to treatment‐emergent or treatment‐related adverse events. In diabetic hypertensive patients, 20 mg/d quinapril plus 5 mg/d amlodipine besylate was a more effective BP‐lowering strategy than monotherapy with 40 mg/d quinapril.