| ŠPINAR, Jindřich, Jiří VÍTOVEC a Miroslav SOUČEK. Anti-hypertensive strategies in patients with MEtabolic parameters, DIabetes mellitus and/or NephropAthy (the M E D I N A study). Biomedical Papers. Olomouc: Palacký University, 2014, roč. 158, č. 3, s. 412-421. ISSN 1213-8118. Dostupné z: https://dx.doi.org/10.5507/bp.2013.053. |
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@article{1136155,
author = {Špinar, Jindřich and Vítovec, Jiří and Souček, Miroslav},
article_location = {Olomouc},
article_number = {3},
doi = {http://dx.doi.org/10.5507/bp.2013.053},
keywords = {hypertension; angiotensin converting enzyme inhibitor; angiotensin receptor blocker; diuretic; calcium-channel blocker; combinations},
language = {eng},
issn = {1213-8118},
journal = {Biomedical Papers},
title = {Anti-hypertensive strategies in patients with MEtabolic parameters, DIabetes mellitus and/or NephropAthy (the M E D I N A study)},
volume = {158},
year = {2014}
}
TY - JOUR
ID - 1136155
AU - Špinar, Jindřich - Vítovec, Jiří - Souček, Miroslav
PY - 2014
TI - Anti-hypertensive strategies in patients with MEtabolic parameters, DIabetes mellitus and/or NephropAthy (the M E D I N A study)
JF - Biomedical Papers
VL - 158
IS - 3
SP - 412-421
EP - 412-421
PB - Palacký University
SN - 12138118
KW - hypertension
KW - angiotensin converting enzyme inhibitor
KW - angiotensin receptor blocker
KW - diuretic
KW - calcium-channel blocker
KW - combinations
N2 - Aims. The primary questions asked by the MEDINA (MEtabolic parameters, DIabetes mellitus and NephropAthy) study are: 1) Do angiotensin converting enzyme inhibitors (ACE-I) have any advantages over angiotensin receptor blockers (ARB)? 2) Should the other drug for combination be a diuretic or a calcium-channel blocker (CCB)? 3) How are the risks reduced by the co administration of a statin? Methods. A total of 439 hypertensive patients with metabolic syndrome and/or diabetes mellitus were randomized to 2 groups: group 1 - ramipril (ACE-I) or perindopril and group 2 - losartan (ARB). Hydrochlorothiazide (diuretic) or amlodipine (CCB) were added to both groups. As a third step, a statin was added. Results. Blood pressure decreased 24.1/13.3 mmHg in the ACE inhibitor group and 25.9/13.5 in the losartan group. The difference was insignificant. Adding either hydrochlorothiazide or amlodipin was equally effective. There were no significant differences on metabolic parameters in the trial arms. Cholesterol level decreased by 0.95 mmol/L in the ACE-I group and 1.02 mmol/L in the ARB group (ns). Conclusion. MEDINA has so far confirmed the equivalence of ACE-I and ARB in hypertension treatment. Adding either diuretic or CCB was equally effective. Our data support the current recommendations on adding a statin to reduce cardiovascular risk.
ER -
ŠPINAR, Jindřich, Jiří VÍTOVEC a Miroslav SOUČEK. Anti-hypertensive strategies in patients with MEtabolic parameters, DIabetes mellitus and/or NephropAthy (the M E D I N A study). \textit{Biomedical Papers}. Olomouc: Palacký University, 2014, roč.~158, č.~3, s.~412-421. ISSN~1213-8118. Dostupné z: https://dx.doi.org/10.5507/bp.2013.053.
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