ŠPINAR, Jindřich, Jiří VÍTOVEC and 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, vol. 158, No 3, p. 412-421. ISSN 1213-8118. Available from: https://dx.doi.org/10.5507/bp.2013.053.
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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
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher Czech Republic
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.200
RIV identification code RIV/00216224:14110/14:00074844
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.5507/bp.2013.053
UT WoS 000345398500013
Keywords in English hypertension; angiotensin converting enzyme inhibitor; angiotensin receptor blocker; diuretic; calcium-channel blocker; combinations
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Soňa Böhmová, učo 232884. Changed: 28/1/2015 12:29.
Abstract
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.
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