Safety and efficacy of candesartan versus valsartan combined with amlodipine on peripheral and central blood pressure

Introduction

“Amlodipine/valsartan” or “amlodipine/candesartan” combinations represent two effective antihypertensive agents with complementary mechanisms of action. Nevertheless, a study has yet to be done to evaluate the effect of amlodipine/candesartan on central blood pressure and compare it with amlodipine/valsartan combination. To see how “amlodipine plus candesartan combination” reduces peripheral and central blood pressure compared to the most studied combination, “amlodipine plus valsartan”.

Material and methods

Eighty-six patients were randomized in an open-label, prospective study by 1:1 ratio to two groups. Group I (n = 42) received the amlodipine and valsartan combination, and group II (n = 44) received the amlodipine and candesartan combination. Peripheral and central blood pressure (CBP) was measured at baseline, at 6 and 12 weeks of follow-up.

Discussion

Both treatment groups reduced peripheral systolic, diastolic, and mean blood pressure. There was no significant difference between and within both groups. The amlodipine/candesartan combination showed more reduction in peripheral systolic blood pressure (PSBP) after 12 weeks of treatment (p = <0.001). Both groups decreased CBP without significant differences between groups. The amlodipine/candesartan combination showed additional efficacy in decreasing CSBP after 12 weeks (p = <0.001). The two treatment groups did not exert significant efficacy in lowering heart rate (HR) and augmentation index% (AIx%).

Conclusion

To conclude, the amlodipine 10 mg/candesartan 16 mg combination was non-inferior to the amlodipine 10 mg/valsartan 160 mg combination in terms of reducing peripheral and CBP over time.