P-181: Lercanidipine improves its antihypertensive effectiveness with no impairment on its good tolerability profile in higher-risk hypertensives. The laura study

• Published in: American journal of hypertension Vol. 17; no. S1; p. 100A
• Main Authors: Barrios, Vivencio, Calderon, Alberto, Navarro, Angel, Noya, Carlos, Tomas, Juan P., Amador, Alejandro, Herranz, Inmaculada, Prieto, Luis, Escobar, Carlos, Blanco, Blanca
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-05-2004
• Subjects: cardiovascular risk; Essential Hypertension; Lercanidipine
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/j.amjhyper.2004.03.256

Lercanidipine exhibits a good antihypertensive efficacy and an excellent tolerability, not only in randomized clinical trials but also in daily clinical practice. With the aim to determine whether the behavior of this drug varies among the cardiovascular risk (CVR) levels, we performed LAURA study. This study analyzed the effect of lercanidipine (10–20 mg od) in grade 1–2 essential hypertensives, according to CVR classification (WHO/ISH 1999). 3175 patients were included (age: 63±10 yrs; 51% women). 43% grade 1 hypertensives. 38% previously untreated. CVR factors: hypercholesterol. (32%), smoking (30%), family history (16%), diabetes (15%). Target organ damage: left ventricular hypertrophy (18%), atherosclerotic plaques (7%), retinopathy I-II (7%), mild renal impairment/microalbum.(5%). Associated clinical conditions: ischemic heart disease (10%), peripheral artery disease (6%), heart failure (4%), nephropathy (4%), cerebrovascular disease (3%), severe retinopathy (1%). 49% of patients were at high or very high-risk: low (7%), medium (44%), high (23%), very high risk (26%). Follow up was 6 months, with visits at 1, 3 and 6 months. Baseline BP: 160±12/ 95±7. BP was progressively higher according to higher CVR grade. BP in low CVR group: 150±5/92±5 and BP in very high CVR: 164±15/97±9. At 6 months, BP reduced to: 136±10/80±7. Most frequent side effects were: edema (5.1%, more frequent with 20 mg), headache (3.3%), flush (2.5%), asthenia (1%). Only 1.7% of the patients discontinued due to adverse events. The evaluation of the drug effect in different CVR groups showed that BP reduction was higher according to the CVR increase. Nevertheless the tolerability was similar for all the CVR groups. In conclusion, lercanidipine showed to be more effective in patients with higher CVR, most likely to be related with higher baseline BP in higher CVR groups. However, although effectiveness improves, its good tolerability does not change. Therefore, lercanidipine is an effective and well-tolerated antihypertensive drug in all the patients, independently of CVR level. The LAURA study is one more evidence of the usefulness of lercanidipine for any hypertensive patient profile in daily clinical practice. Am J Hypertens (2004) 17, 100A–100A; doi: 10.1016/j.amjhyper.2004.03.256