Comparison of the fixed combination of enalapril/diltiazem ER and their monotherapies in stage 1 to 3 essential hypertension

William Cushman, Jerome D. Cohen, Randolph P. Jones, Thomas C. Marbury, Robert B. Rhoades, Leo Kent Smith

Research output: Contribution to journalArticle

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Abstract

The safety and efficacy of two fixed dose combinations of enalapril and diltiazem extended release formation (ER) (E/D) were compared with their monotherapies and placebo in patients with stage 1 to 3 hypertension. The trial design was a multicenter, randomized, double blind, placebo controlled, parallel group, 12 week treatment phase, followed by a 36 week, open label phase. A total of 891 patients with sitting diastolic blood pressure (SiDBP) between 95 and 115 mmHg were randomly assigned to enalapril 5 mg, diltiazem ER 120 mg, diltiazem ER 180 mg, enalapril 5 mg/diltiazem ER 120 mg (E5/D120), enalapril 5 mg/diltiazem ER 180 mg (E5/D180), or placebo. In the open label phase, 562 patients received the fixed combination, titrated as needed to control SiDBP < 90 mmHg. Efficacy was determined with trough (24 ± 2 h postdose) sitting blood pressure measurements at week 12 and at the end of the open label part of the study. Safety was evaluated based on patient symptoms, clinical laboratories, and electrocardiograms (ECG). E5/D120 and E5/D180 significantly reduced trough SiDBP (-7.6 and -8.3 mmHg, respectively; P < .05) versus their monotherapies. E5/D120 and E5/D180 significantly reduced trough sitting systolic blood pressure (-7.9 and -9.0, respectively; P < .05) versus both diltiazem ER monotherapies. All active treatments significantly decreased SiDBP and SiSBP versus placebo. E/D effectively lowered SiDBP and SiSBP during the open label extension. No significant difference was seen among treatment groups for the overall incidence of adverse events. The most common drug related adverse events were headache, edema/swelling, dizziness, asthenia/fatigue, cough, rash, and impotence. The event frequency for the combinations were similar to those seen with the monotherapies. Fixed combinations of E/D were generally well tolerated, with an increased blood pressure lowering effect as compared with the individual components in patients with stage I to III hypertension.

Original languageEnglish (US)
Pages (from-to)23-30
Number of pages8
JournalAmerican journal of hypertension
Volume11
Issue number1
DOIs
StatePublished - Jan 1 1998

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Enalapril
Diltiazem
Blood Pressure
Placebos
Essential Hypertension
Hypertension
Safety
Asthenia
Dizziness
Erectile Dysfunction
Exanthema
Drug-Related Side Effects and Adverse Reactions
Cough
Fatigue
Headache

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Comparison of the fixed combination of enalapril/diltiazem ER and their monotherapies in stage 1 to 3 essential hypertension. / Cushman, William; Cohen, Jerome D.; Jones, Randolph P.; Marbury, Thomas C.; Rhoades, Robert B.; Smith, Leo Kent.

In: American journal of hypertension, Vol. 11, No. 1, 01.01.1998, p. 23-30.

Research output: Contribution to journalArticle

Cushman, William ; Cohen, Jerome D. ; Jones, Randolph P. ; Marbury, Thomas C. ; Rhoades, Robert B. ; Smith, Leo Kent. / Comparison of the fixed combination of enalapril/diltiazem ER and their monotherapies in stage 1 to 3 essential hypertension. In: American journal of hypertension. 1998 ; Vol. 11, No. 1. pp. 23-30.
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