Amlodipine-Benazepril Therapy for Blood Pressure Variability and Prognosis in Elderly Patients with Postprandial Hypotension

Postprandial hypotension (PPH), a common but underdiagnosed condition in elderly hypertensive patients, is associated with increased cardiovascular risk and mortality. Blood pressure variability (BPV), another independent prognostic factor, is often exacerbated in this population due to impaired autonomic function. This single-center retrospective study evaluated the effects of amlodipine-benazepril combination therapy compared with monotherapy in 150 patients aged ≥65 years diagnosed with hypertension and PPH. Patients were assigned to three groups (amlodipine-benazepril, amlodipine, or benazepril), and outcomes included the incidence of PPH after 4 weeks, 24 h ambulatory BPV at 6 months, changes in carotid intima-media thickness (cIMT), Crouse plaque score, renal function, left ventricular mass index (LVMI), and major adverse cardiovascular events (MACE) over 12 months. The combination therapy group demonstrated a lower incidence of PPH, greater reductions in BPV, improved vascular and renal parameters, and fewer MACE compared with either monotherapy group. No severe adverse events were reported. These findings provide preliminary evidence that amlodipine-benazepril combination therapy may enhance hemodynamic stability and organ protection in elderly patients with PPH. However, given the retrospective, single-center design, the results should be interpreted with caution, and larger prospective studies are warranted.