Combination therapy with lercanidipine and enalapril in the management of the hypertensive patient: an update of the evidence

Figures & data

Figure 1 Drug combinations.

Abbreviations: ACE inh: angiotensin-converting enzyme inhibitors; ARBs, angiotensin receptor blockers; BP, blood pressure; CCBs, calcium channel blockers.

Table 1 Combination of antihypertensive therapies

Study	Combination	Result
LIFE^Citation22	Losartan + HCT vs atenolol + HCT	5 years primary CV end point: 13% reduction
VALUE^Citation23	Amlodipine + HCT/valsartan + HCT vs valsartan or amlodipine alone	2 years BP control: 14.4% reduction
HYVET^Citation24	Indapamide alone or indapamide + perindopril vs placebo	2 years CV event: 34% reduction 2 years heart failure: 64% reduction 2 years stroke: 30% reduction
HOPE^Citation25	Ramipril vs placebo	5 years CV events: 2% reduction 5 years myocardial infarction: 2.4% reduction 5 years stroke: 1.5% reduction
FEVER^Citation26	Felodipine + HCT vs placebo + HCT	3.3 years CV events: 27% reduction 3.3 years cardiac events: 35% reduction 3.3 years death by any cause: 31% reduction
ACCOMPLISH^Citation27	Benazepril + amlodipine vs benazepril + HCT	3 years CV event: 20% reduction 3 years myocardial infarction: 22% reduction 3 years stroke: 16% reduction
ASCOT^Citation28	Amlodipine + perindopril vs atenolol + bendroflumethiazide	5.5 years CV event: 26% reduction 5.5 years stroke: 23% reduction 5.5 years all-cause mortality: 11% reduction
INVEST^Citation29	Verapamil + trandolapril vs atenolol + HCT	2.7 years CV disease: similar outcome
EUROPA^Citation30	Patients medication + perindopril vs patients medication + placebo	4.2 years CV mortality: 14% reduction 4.2 years nonfatal myocardial infarction: 22% reduction 4.2 years total mortality: 11% reduction

Abbreviations: BP, blood pressure; CV, cardiovascular; HCT, hydrochlorothiazide.

Table 2 Pharmacology of lercanidipine and enalapril

Pharmacological characteristics	Lercanidipine	Enalapril
Molecular weight	648.2	492.53
Form	Citrine powder	Off-white powder
Solubility in water	No	Yes
Half-life	3 hours	1.3 hours
Absorption	Gastrointestinal	Gastrointestinal
Secretion	Urine, feces	Urine, feces

Table 3 Incidence of side effects by monotherapy and lercanidipine/enalapril combination treatment

Study	Lercanidipine	Lercanidipine + enalapril
Puig et al^Citation48	Side effects: 12%	Side effects: 14%
Maldonado et al^Citation50	–	Side effects: 0.3%
Mancia et al^Citation58	L 10 mg side effects: 6%	L 10 mg + E 10 mg side effects: 8.5% L 10 mg + E 20 mg side effects: 10.2%
	L 20 mg side effects: 8.8%	L 20 mg + E 10 mg side effects: 8.9% L 20 mg + E 20 mg side effects: 8.6%
Scholze et al^Citation60		L 10 mg + E 20 mg side effects: 3.4%

Abbreviations: L, lercanidipine; E, enalapril.

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