Combined use of amlodipine and folic acid are significantly more efficacious than amlodipine alone in lowering plasma homocysteine and blood pressure among hypertensive patients with hyperhomocysteinemia and intolerance to ACEI: A multicenter, randomized, double‐blind, parallel‐controlled clinical trial

Autor: Huihui Bao, Xiao Huang, Ping Li, Changsheng Sheng, Jin Zhang, Zhirong Wang, Demin Song, Lihua Hu, Congcong Ding, Zaihua Cheng, Chen Yao, Guangliang Chen, Yimin Cui, Xianhui Qin, Genfu Tang, Xiaobin Wang, Yong Huo, Xiaoshu Cheng, Jiguang Wang
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: The Journal of Clinical Hypertension, Vol 25, Iss 8, Pp 689-699 (2023)
Druh dokumentu: article
ISSN: 1751-7176
1524-6175
DOI: 10.1111/jch.14697
Popis: Abstract Hyperhomocysteinemia with hypertension can synergistically increase the risk of stroke. The China stroke primary prevention trial showed that combining 0.8 mg folic acid (FA) with angiotensin‐converting enzyme inhibitor (ACEI) can effectively lower plasma total homocysteine (tHcy) and blood pressure (BP); and reduce first stroke risk by additional 21% compared to ACEI alone. However, intolerance to ACEI is common in Asians and amlodipine can be alternative. This is a multicenter, randomized, double‐blind, parallel‐controlled clinical trial (RCT) which evaluated whether amlodipine combined with FA is more efficacious than amlodipine alone in lowering tHcy and BP among Chinese hypertensive with hyperhomocysteinemia and intolerance to ACEI. 351 Eligible patients were randomly assigned by 1:1:1 ratio to receive amlodipine‐FA tablet daily (amlodipine 5 mg/FA 0.4 mg, A group); amlodipine 5 mg/FA 0.8 mg tablet daily (B group); amlodipine 5 mg daily (C group, control group). Follow‐up was conducted at 2, 4, 6, and 8 weeks. The primary outcome was efficacy of lowering both tHcy and BP at the end of 8‐week treatment. Compared with C group, A group had a significantly higher rate of lowering both tHcy and BP (23.3% vs. 6.0%; Odds Ratio [OR], 8.68; 95% CI, 3.04‐24.78, P
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