The effect of antihypertensive agents in people at high risk of cardiovascular disease and diabetes: a view through smoke and mirrors.

摘要

The paper by Francisco Javier Martinez-Martin et al.' reports a study of the effect of treatment with olmesartan/amlodipine and olmesartan/hydrochlor-othiazide on inflammatory and metabolic markers in people with hypertension and the metabolic syndrome. Blood pressure, albuminuria and C-reactive protein were reduced similarly in both groups. However, only olmesartan/amlodipine reduced insulin resistance, other inflammatory markers and increased plasma adiponectin. The risk of new-onset diabetes was also significantly less with this combination. Thus, there were clear differences between the two olmesartan-based combinations. It is suggested that the combination with amlodipine may have advantages in such high-risk individuals. The benefit of blood pressure lowering was established by virtue of high-quality, robust data from large trials with hard end points.