Combined therapy with candesartan and amlodipine in the treatment of hypertension in a young obese patient Case report
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Published:
Dec 31, 2024
Keywords:
candesartan, amlodipine, hypertension, metabolic syndrome
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Abstract
Hypertension requires long-term pharmacological therapy. Key challenges are selecting the appropriate drug class and achieving patient compliance. Using a single-pill combination therapy may enhance treatment effectiveness. This article describes the case of a 42-year-old patient diagnosed with hypertension, prediabetes, and metabolic syndrome. Due to the patient’s profile – metabolic dysregulation and increased cardiovascular risk – an individualized treatment plan was necessary. Based on studies demonstrating the high efficacy of the candesartan and amlodipine combination for the treatment of hypertension and considering the metabolic syndrome and young age of the patient combined therapy with candesartan and amlodipine was introduced. After three months, target blood pressure and metabolic parameters within the normal range were achieved. Combined therapy with candesartan and amlodipine is an effective treatment option for hypertension, especially in patients with metabolic syndrome and diabetes. Individualized therapy and consideration of patient preferences increase the likelihood of therapeutic success and blood pressure control.
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How to Cite
Skwarek, A., & Ozierański, K. (2024). Combined therapy with candesartan and amlodipine in the treatment of hypertension in a young obese patient. Medycyna Faktow (J EBM), 17(4(65), 576-582. https://doi.org/10.24292/01.MF.0424.23
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References
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2. Chang TE, Ritchey MD, Park S et al. National Rates of Nonadherence to Antihypertensive Medications Among Insured Adults With Hypertension, 2015. Hypertension. 2019; 74(6): 1324-32.
3. McEvoy JW, McCarthy CP, Bruno RM et al. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension: Developed by the task force on the management of elevated blood pressure and hypertension of the European Society of Cardiology (ESC) and endorsed by the European Society of Endocrinology (ESE) and the European Stroke Organisation (ESO). Eur Heart J. 2024; 45(38): 3912-4018.
4. Dobrowolski P, Prejbisz A, Kuryłowicz A et al. Zespół metaboliczny – nowa defini-cja i postępowanie w praktyce. Stanowisko PTNT, PTLO, PTL, PTH, PTMR, PTMSŻ, Sekcji Prewencji i Epidemiologii PTK, „Klubu 30” PTK oraz Sekcji Chirurgii Metabolicznej i Bariatrycznej TChP. Lekarz POZ. 2022; 8(3).
5. Visseren FLJ, Mach F, Smulders YM et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC). Eur Heart J. 2021; 42(34): 3227-337.
6. Nazarzadeh M, Bidel Z, Canoy D et al. Blood pressure lowering and risk of new-onset type 2 diabetes: an individual participant data meta-analysis. Lancet. 2021; 398(10313): 1803-10.
7. SCORE2-Diabetes: 10-year cardiovascular risk estimation in type 2 diabetes in Europe. Eur Heart J. 2023; 44(28): 2544-56.
8. Zannad F, Fay R. Blood pressure-lowering efficacy of olmesartan relative to other angiotensin II receptor antagonists: an overview of randomized controlled studies. Fundamental & Clinical Pharmacology. 2007; 21: 181-90.
9. Marx N, Federici M, Schütt K et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023; 44(39): 4043-140.
10. Nishio K, Kondo T, Kobayashi Y. Efficacy and Tolerability of Candesartan Cilexetil and Amlodipine in Patients with Poorly Controlled Essential Hypertension. Int J Clin Med. 2011; 2011: 64-8.
11. Althanoon ZA, Thanoon IAJ. Comparative Effects of Amlodipine and Candesartan on Blood Pressure and Metabolic Profile in Non-Diabetic Hypertensive Patients. Pharmacogn J. 2022; 14(1): 141-7.
12. Ogihara T, Nakao K, Fukui T et al. Effects of Candesartan Compared With Amlodipine in Hypertensive Patients With High Cardiovascular Risks: Candesartan Antihypertensive Survival Evaluation in Japan Trial. Hypertension. 2008; 51: 393-8.
13. Maeda A, Tamura K, Kanaoka T et al. Combination Therapy of Angiotensin II Receptor Blocker and Calcium Channel Blocker Exerts Pleiotropic Therapeutic Effects in Addition to Blood Pressure Lowering: Amlodipine and Candesartan Trial in Yokohama (ACTY). Clinical and Experimental Hypertension. 2012; 34: 249-57.
14. Khawaja Z, Wilcox CS. An overview of candesartan in clinical practice. Expert Rev Cardiovasc Ther. 2011; 9(8): 975-82.
15. Gradman AH, Lewin AJ, Bowling BT et al. Comparative effects of candesartan cilexetil and losartan in patients with systemic hypertension. Candesartan Versus Losartan Efficacy Comparison (CANDLE) Study Group. Heart Dis. 1999; 12: 52-7.
16. Bakris GL, Gradman AH, Reif M et al. Antihypertensive Efficacy of Candesartan in Comparison to Losartan: The CLAIM Study. J Clin Hypertens (Greenwich). 2001; 3(1): 16-21.
17. Elmfeldt D, Olofsson B, Meredith PA. The Relationships Between Dose and Antihypertensive Effect of Four AT1-receptor Blockers. Differences in Potency and Efficacy. Blood Press. 2002; 11: 293-301.
18. Fridman K, Elmfeldt D, Wysocki M et al. Influence of AT1 Receptor Blockade on Blood Pressure, Renal Haemodynamics and Hormonal Responses to Intravenous Angiotensin II Infusion in Hypertensive Patients. Blood Press. 2002; 11: 244-52.
19. Julius S. Amlodipine in hypertension: an overview of the clinical dossier. J Cardiovasc Pharmacol. 1988; 12(Suppl 7): S27-33.
20. Makani H, Bangalore S, Romero J et al. Effect of renin-angiotensin system blockade on calcium channel blocker-associated peripheral edema. Am J Med. 2011; 124(2): 128-35.