Long-Term Dual Blockade With Candesartan and Lisinopril in Hypertensive Patients With Diabetes
The CALM II study
- Niels H. Andersen, MD, PHD1,
- Per. L Poulsen, MD, DMSC1,
- Søren T. Knudsen, MD, PHD1,
- Steen H. Poulsen, MD, DMSC2,
- Hans Eiskjær, MD, DMSC2,
- Klavs W. Hansen, MD, DMSC3,
- Kjeld Helleberg, MD4 and
- Carl E. Mogensen, MD, DMSC1
- 1Department of Internal Medicine M (Diabetes & Endocrinology), Aarhus University Hospital, Aarhus, Denmark
- 2Department of Cardiology B, Aarhus University Hospital, Aarhus, Denmark
- 3Department of Internal Medicine, Silkeborg Hospital, Silkeborg, Denmark
- 4Department of Internal Medicine, Viborg Hospital, Viborg, Denmark
- Address correspondence and reprint requests to Niels Holmark Andersen, MD, Department of Internal Medicine, Diabetes & Endocrinology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark. E-mail: holmark{at}ki.au.dk
Abstract
OBJECTIVE—To assess and compare the long-term effects of the combination of candesartan and lisinopril with high-dose lisinopril on systolic blood pressure in patients with hypertension and diabetes.
RESEARCH DESIGN AND METHODS—This was a prospective, randomized, parallel-group, double-blind, double-dummy study with a 12-month follow-up. Drug therapy was either lisinopril 40 mg once daily or dual-blockade treatment with candesartan 16 mg once daily and lisinopril 20 mg once daily. The study comprised 75 type 1 and type 2 diabetic patients aged 35–74 years. The main outcome measures were seated and 24-h ambulatory systolic blood pressure.
RESULTS—Reduction in systolic blood pressure (24-h systolic blood pressure) reduction was obtained in both treatment arms (mean reduction at final follow-up: dual blockade 6 mmHg vs. lisinopril 2 mmHg), but no significant difference was found between dual-blockade and lisinopril 40 mg once daily (P = 0.10). Both treatments were generally well tolerated, and similar low rates of side effects were found in the two groups.
CONCLUSIONS—There was no statistically significant difference between lisinopril 40 mg once daily and lisinopril 20 mg in combination with candesartan 16 mg once daily in reducing systolic blood pressure in hypertensive patients with diabetes.
- AIIA, angiotensin II receptor blocker
- CALM, Candesartan and Lisonopril Microaluminuria
- UACR, urine albumin-to-creatinine ratio
Footnotes
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C.E.M. has received speaking fees from, has been a paid consultant of, and has received research funding from AstraZeneca.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted October 28, 2004.
- Received August 24, 2004.
- DIABETES CARE
