The association of amlodipine with isosorbide-5-mononitrate in the treatment of ischemic-hypertensive cardiopathy [Associazione di amlodipina con isosorbide-5-mononitrato nel trattamento della cardiopatia ischemico-ipertensiva]

Abstract Every form of therapy must always aim at obtaining maximum benefit with minimum use of drugs; also for the purpose of ensuring maximum patient compliance. With this end in mind, 21 patients with ischemic heart disease and arterial hypertension were divided into three groups of seven subjects each and submitted to different drug treatments with single daily doses: group 1 received isosorbide-5-mononitrate (60 mg), group 2 amlodipine (10 mg), and group 3 a combination of both drugs at the same dosage, for four weeks. Statistical analysis showed blood pressure values to have been significantly reduced in subjects receiving amlodipine both alone and in combination (p less than 0.05) while no significant variation was observed (p = n.s.) in those treated with isosorbide-5-mononitrate only. A significant reduction of diastolic blood pressure (p less than 0.05) occurred only in patients talking the combination. No significant changes of heart rate (p = n.s.) were observed in any of the groups. Tests at the cycling ergometer revealed increased in any of the groups. Tests at the cycling ergometer revealed increased maximal effort tolerance for all three groups but the increase was more marked in patients taking the combination (who from 130 +/- 10 Watt increased to 160 +/- 20 Watt). This was confirmed also by the reduced consumption of trinitrine capsules which diminished in groups 1 and 2 from an average of 5/week to 2/week but was completely abolished in group 3. Also ST depression was significantly reduced (p less than 0.05) only in this latter group