RT Journal Article
T1 Blood pressure-lowering effects of nifedipine/candesartan combinations in high-risk individuals: subgroup analysis of the DISTINCT randomised trial
A1 Mancia, G
A1 Cha, G
A1 Gil-Extremera, B
A1 Harvey, P
A1 Lewin, A J
A1 Villa, G
A1 Kjeldsen, S E
K1 Bencimidazoles
K1 Compuestos de bifenilo
K1 Presión sanguínea
K1 Índice de masa corporal
K1 Diabetes mellitus Tipo 2
K1 Tasa de filtración glomerular
K1 Humanos
K1 Hipercolesterolemia
K1 Hipertensión
K1 Nifedipino
K1 Factores de riesgo
AB The DISTINCT study (reDefining Intervention with Studies Testing Innovative Nifedipine GITS-Candesartan Therapy) investigated the efficacy and safety of nifedipine GITS/candesartan cilexetil combinations vs respective monotherapies and placebo in patients with hypertension. This descriptive sub-analysis examined blood pressure (BP)-lowering effects in high-risk participants, including those with renal impairment (estimated glomerular filtration rate<90 ml min(-1), n=422), type 2 diabetes mellitus (n=202), hypercholesterolaemia (n=206) and cardiovascular (CV) risk factors (n=971), as well as the impact of gender, age and body mass index (BMI). Participants with grade I/II hypertension were randomised to treatment with nifedipine GITS (N) 20, 30, 60 mg and/or candesartan cilexetil (C) 4, 8, 16, 32 mg or placebo for 8 weeks. Mean systolic BP and diastolic BP reductions after treatment in high-risk participants were greater, overall, with N/C combinations vs respective monotherapies or placebo, with indicators of a dose-response effect. Highest rates of BP control (ESH/ESC 2013 guideline criteria) were also achieved with highest doses of N/C combinations in each high-risk subgroup. The benefits of combination therapy vs monotherapy were additionally observed in patient subgroups categorised by gender, age or BMI. All high-risk participants reported fewer vasodilatory adverse events in the pooled N/C combination therapy than the N monotherapy group. In conclusion, consistent with the DISTINCT main study outcomes, high-risk participants showed greater reductions in BP and higher control rates with N/C combinations compared with respective monotherapies and lesser vasodilatory side-effects compared with N monotherapy.
PB Nature Publishing Group
SN 1476-5527
YR 2017
FD 2017-03
LK http://hdl.handle.net/10668/2610
UL http://hdl.handle.net/10668/2610
LA en
NO Mancia G, Cha G, Gil-Extremera B, Harvey P, Lewin AJ, Villa G et al. Blood pressure-lowering effects of nifedipine/candesartan combinations in high-risk individuals: subgroup analysis of the DISTINCT randomised trial. J Hum Hypertens. 2017 Mar;31(3):178-188.
DS RISalud
RD Apr 12, 2025