Alpha-blockade and XXXX antagonism: an effective and well-tolerated combination for the treatment of resistant @entity101 .

@entity1 @entity4688 @entity1289 @entity101 @entity551 @entity16427 @entity3591 @entity460 @entity1063
OBJECTIVE: To test whether the combination of @entity460 antagonism is additive with the other newer antihypertensives, namely alpha-blockers and @entity1289 ( @entity1289 ) inhibitors. DESIGN: Three-way double-blind, Latin-square crossover studies in two groups of 12 @entity1 with essential @entity101 . The three treatment periods were @entity3591 , @entity16427 (study A) or enalapril (study B), and the combination of @entity3591 with the second drug. METHODS: Each treatment was taken for 1 month, preceded by a 2-week single-blind run-in period, in which the @entity1 received a low dose of @entity16427 (study A) or @entity4688 (study B) to enable recruitment of @entity1 with moderate or severe @entity101 . Blood pressure, foot volume and plasma @entity1063 concentration were measured at the end of each run-in and treatment period. RESULTS: The combination of alpha-blockade and @entity460 antagonism caused a @entity551 . These falls were significantly greater than on either drug alone, and greater than the sum of the falls when taking the individual drugs. The combination of @entity3591 and the @entity1289 inhibitor was also additive. Both combinations with @entity3591 were tolerated well by all @entity1 . CONCLUSIONS: The combination of alpha-blockade and @entity460 antagonism has not previously been studied and should be useful for resistant @entity101 who have not tolerated beta-blockade or @entity1289 inhibitors. The combination of @entity1289 inhibition and @entity460 antagonism has previously been shown to be additive; its use as a positive control in the present studies suggests that the use of an active drug for a run-in period may be a useful design for permitting the study of @entity1 from whom all treatment cannot safely be withdrawn.
