News
Amlodipine Added to Quinapril vs Quinapril Alone for the Treatment of Hypertension in Diabetes: The Amlodipine in Diabetes (ANDI) Trial
This randomized, comparative, parallel-group trial investigated strategies of blood pressure (BP)-lowering in patients with diabetes and hypertension.
Patients not reaching goal BP (<13080 mm Hg) after 4-week open-label treatment with quinapril 20 mgd (n=374) received 40 mgd quinapril (n=167) or 20 mgd quinapril plus amlodipine besylate (5 mgd; n=162) for 6 weeks. Patients receiving combination therapy vs monotherapy had significantly greater reductions in mean ± SE sitting systolic BP (9.9±1.0 mm Hg vs 4.3±1.1 mm Hg; P<.001) and diastolic BP (6.5±0.6 mm Hg vs 2.7±0.6 mm Hg; P<.001). No significant differences between groups were observed in percentage of patients achieving goal BP (10.1 with combination therapy vs 8.2 with monotherapy). A clinically neutral effect was observed on high-sensitivity C-reactive protein in both groups. Treatments were well tolerated; fewer than 3 of patients in any group discontinued due to treatment-emergent or treatment-related adverse events. In diabetic hypertensive patients, 20 mgd quinapril plus 5 mgd amlodipine besylate was a more effective BP-lowering strategy than monotherapy with 40 mgd quinapril.