Differential effects of strict blood pressure lowering by losartan/hydrochlorothiazide combination therapy and high-dose amlodipine monotherapy on microalbuminuria: The ALPHABET study

Motoki Fukutomi, Satoshi Hoshide, Kazuo Eguchi, Tomonori Watanabe, Kazuyuki Shimada, Kazuomi Kario

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

We investigated the effects of losartan/hydrochlorothiazide (HCTZ) fixed combination therapy and high-dose amlodipine monotherapy on BP measurements and target organ protection. In this open-label multicenter trial, hypertensive patients were randomly allocated to receive losartan 50 mg or amlodipine 5 mg for 4 weeks, and the treatments were changed to combination of losartan 50 mg/HCTZ 12.5 mg or amlodipine 10 mg for a further 4 weeks. A total of 91 hypertensive patients (age 63.6 years), 47 in the losartan/HCTZ group and 44 in amlodipine group, were enrolled. After 8 weeks, the clinic BP, home BP, and 24-hour ambulatory BP were successfully controlled to the same level in both treatment groups (P < .001). Furthermore, both groups showed the same degree of BP reduction in the 24-hour, daytime, and nighttime (P <.001). B-type natriuretic peptide (BNP) also significantly decreased to the same level in both groups, whereas the reduction of urinary albumin/creatinine ratio (UACR) was greater in the losartan/HCTZ group than in the high-dose amlodipine group (-47.6% vs 2.4%, P <.001). Losartan/HCTZ combination and high-dose amlodipine have similar effects on clinic, home, and ambulatory BP control and BNP reduction, whereas losartan/HCTZ has superior effect on UACR reduction when compared with high-dose amlodipine.

Original languageEnglish
Pages (from-to)73-82
Number of pages10
JournalJournal of the American Society of Hypertension
Volume6
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Keywords

  • Losartan/hydrochlorothiazide
  • high-dose amlodipine
  • home blood pressure
  • microalbuminuria

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