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 and Miroslav SOUČEK

Basic information

Original name

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

Authors

ŠPINAR, Jindřich (203 Czech Republic, guarantor, belonging to the institution), Jiří VÍTOVEC (203 Czech Republic, belonging to the institution) and Miroslav SOUČEK (203 Czech Republic, belonging to the institution)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.200

RIV identification code

RIV/00216224:14110/14:00074844

Organization unit

Faculty of Medicine

DOI

UT WoS

000345398500013

Keywords in English

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

Tags

Tags

International impact, Reviewed
Změněno: 28/1/2015 12:29, Soňa Böhmová

Abstract

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.