J 2014

Anti-hypertensive strategies in patients with MEtabolic parameters, DIabetes mellitus and/or NephropAthy (the M E D I N A study)

ŠPINAR, Jindřich, Jiří VÍTOVEC a Miroslav SOUČEK

Základní údaje

Originální název

Anti-hypertensive strategies in patients with MEtabolic parameters, DIabetes mellitus and/or NephropAthy (the M E D I N A study)

Autoři

ŠPINAR, Jindřich (203 Česká republika, garant, domácí), Jiří VÍTOVEC (203 Česká republika, domácí) a Miroslav SOUČEK (203 Česká republika, domácí)

Vydání

Biomedical Papers, Olomouc, Palacký University, 2014, 1213-8118

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 1.200

Kód RIV

RIV/00216224:14110/14:00074844

Organizační jednotka

Lékařská fakulta

DOI

UT WoS

000345398500013

Klíčová slova anglicky

hypertension; angiotensin converting enzyme inhibitor; angiotensin receptor blocker; diuretic; calcium-channel blocker; combinations

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 28. 1. 2015 12:29, Soňa Böhmová

Anotace

V originále

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.