Antihypertensive profiles with ascending dose combinations of ramipril andfelodipine ER

The aim of the study was to identify the most appropriate dosage combinatio n of ramipril and felodipine ER tan extended release tablet) for mild-to-mo derate hypertension. Hypertensive patients (N=507) with supinediastolic blood pressure (DBP) val ues between 100-115 mmHg were included in a randomized, multicenter, double -blind study of 3 x 4 factorial design with a 2 - 4 week single-blind, plac ebo run-in and 6 week active treatment phase. The patients were randomized to 12 groups: placebo, ramipril (2.5, 5, 10 mg ), felodipine ER (5, 10 mg), or ramipril-felodipine ER combinations (2.5/5 mg, 2.5/10 mg, 5/5 mg, 5/10 mg, 10/5 mg, 10/10 mg). Although the greatest reductions in blood pressure were observed with ramip ril-felodipine ER (10/10 mg), consideration of the antihypertensive efficac y and safety factors suggest that the ramipril-felodipine ER (5/5 mg) combi nation has the Best efficacy/tolerability ratio of the combinations tested. The incidence of adverse events with ramipril-felodipine ER combination th erapy was similar to that with felodipine ER monotherapy, but peripheral ed ema, tachycardia and vasodilatation occurred less frequently with ramipril- felodipine ER (5/5 mg) combination than with felodipine ER monotherapy. The combination of ramipril-felodipine ER (5/5 mg) can be considered to be the most suitable option for hypertensive patients with an inadequate response to either of the monocomponents.