TY - JOUR
T1 - Effectiveness of initiating treatment with valsartan/hydrochlorothiazide in patients with stage-1 or stage-2 hypertension
AU - Zappe, D. H.
AU - Palmer, B. F.
AU - Calhoun, D. A.
AU - Purkayastha, D.
AU - Samuel, R.
AU - Jamerson, K. A.
N1 - Funding Information:
KAJ: Consultant for Novartis Pharmaceuticals Corporation, Merck and Daiichi Sankyo; received lecture fees from Novartis Pharmaceuticals Corporation, Abbott, Bristol-Myers Squibb, GlaxoSmithKline and Merck; received research support from Novartis Pharmaceuticals Corporation and King Pharmaceuticals.
PY - 2010/7
Y1 - 2010/7
N2 - This prospective, 6-week, multicenter, double-blind study examined the benefits of initiating treatment with combination valsartan/hydrochlorothiazide (HCTZ) compared with initial valsartan monotherapy for 648 patients with stage-1 or stage-2 hypertension (age=52.6±10 years; 54% male; baseline blood pressure (BP)=161/98 mm Hg, 32% stage 1). Patients were randomized to valsartan 80 mg (V-low), valsartan 160 mg (V-high) or valsartan/HCTZ 160/12.5 mg (V/HCTZ), and electively titrated after weeks 2 and 4 to the next dosage level (maximum dose valsartan/HCTZ 160/25 mg) if BP remained >140/90 mm Hg. At end of the study, patients initiated with V/HCTZ required less titration steps compared with the initial valsartan monotherapy groups (63 vs 86% required titration by study end, respectively) and reached the target BP goal of <140/90 mm Hg in a shorter period of time (2.8 weeks) (P<0.0001) vs V-low (4.3 weeks) and V-high (3.9 weeks). Initial combination therapy was also associated with higher BP control rates and greater reductions in both systolic and diastolic BP from baseline (63%, -27.7±13/-15.1±8mmHg) compared with V-low (46%, -21.2±13/-11.4±8mmHg, P<0.0001) or V-high (51%, -24.0±13/-12.0±10mmHg, P<0.01). Overall and drug-related AEs were mild to moderate and were similar between V/HCTZ (53.1 and 14.1%, respectively) and the two monotherapy groups, V-low (50.5 and 13.8%) and V-high (50.7 and 11.8%). In conclusion, initiating therapy with a combination of valsartan and low-dose HCTZ results in early, improved BP efficacy with similar tolerability as compared with starting treatment with a low or higher dose of valsartan for patients with stage-1 and stage-2 hypertension.
AB - This prospective, 6-week, multicenter, double-blind study examined the benefits of initiating treatment with combination valsartan/hydrochlorothiazide (HCTZ) compared with initial valsartan monotherapy for 648 patients with stage-1 or stage-2 hypertension (age=52.6±10 years; 54% male; baseline blood pressure (BP)=161/98 mm Hg, 32% stage 1). Patients were randomized to valsartan 80 mg (V-low), valsartan 160 mg (V-high) or valsartan/HCTZ 160/12.5 mg (V/HCTZ), and electively titrated after weeks 2 and 4 to the next dosage level (maximum dose valsartan/HCTZ 160/25 mg) if BP remained >140/90 mm Hg. At end of the study, patients initiated with V/HCTZ required less titration steps compared with the initial valsartan monotherapy groups (63 vs 86% required titration by study end, respectively) and reached the target BP goal of <140/90 mm Hg in a shorter period of time (2.8 weeks) (P<0.0001) vs V-low (4.3 weeks) and V-high (3.9 weeks). Initial combination therapy was also associated with higher BP control rates and greater reductions in both systolic and diastolic BP from baseline (63%, -27.7±13/-15.1±8mmHg) compared with V-low (46%, -21.2±13/-11.4±8mmHg, P<0.0001) or V-high (51%, -24.0±13/-12.0±10mmHg, P<0.01). Overall and drug-related AEs were mild to moderate and were similar between V/HCTZ (53.1 and 14.1%, respectively) and the two monotherapy groups, V-low (50.5 and 13.8%) and V-high (50.7 and 11.8%). In conclusion, initiating therapy with a combination of valsartan and low-dose HCTZ results in early, improved BP efficacy with similar tolerability as compared with starting treatment with a low or higher dose of valsartan for patients with stage-1 and stage-2 hypertension.
KW - initial combination therapy
KW - valsartan
KW - valsartan/hydrochlorothiazide
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U2 - 10.1038/jhh.2009.90
DO - 10.1038/jhh.2009.90
M3 - Article
C2 - 20010618
AN - SCOPUS:77953809954
SN - 0950-9240
VL - 24
SP - 483
EP - 491
JO - Journal of Human Hypertension
JF - Journal of Human Hypertension
IS - 7
ER -