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Clinical efficacy and safety of olmesartan/hydrochlorothiazide combination therapy in patients with essential hypertension.

Ruilope LM - Vasc Health Risk Manag (2008)

Bottom Line: Guidelines recommend that many patients will require two or more antihypertensive agents from different classes.Combining an angiotensin II receptor blocker (ARB) with hydrochlorothiazide (HCTZ) has been shown in clinical studies to increase the antihypertensive efficacy of both agents compared with either agent alone.Thus olmesartan/HCTZ is a well-tolerated option for patients who fail to respond to monotherapy and as initial therapy in those who require large reductions in diastolic blood pressure or systolic blood pressure to achieve goal blood pressure.

View Article: PubMed Central - PubMed

Affiliation: Unidad de Hipertensión, Hospital 12 de Octubre, Madrid, Spain. ruilope@ad-hocbox.com

ABSTRACT
Hypertension is a major risk factor for cardiovascular disease that contributes to the premature death of millions of people each year, and identification and treatment of hypertension continues to be a challenge. Guidelines recommend that many patients will require two or more antihypertensive agents from different classes. Combining an angiotensin II receptor blocker (ARB) with hydrochlorothiazide (HCTZ) has been shown in clinical studies to increase the antihypertensive efficacy of both agents compared with either agent alone. This review covers several clinical trials and aims to examine several aspects of the efficacy of the combination of olmesartan and HCTZ, including dose-responsiveness, long-term efficacy, goal rate achievement, and efficacy in patients with moderate to severe hypertension. The results presented here demonstrate that olmesartan is effective when added to HCTZ monotherapy or when HCTZ is added to olmesartan monotherapy, both over the short and long term. Moderate to severe hypertension responds well to olmesartan/HCTZ combination therapy, and the great majority of patients are able to achieve recommended blood pressure targets. Thus olmesartan/HCTZ is a well-tolerated option for patients who fail to respond to monotherapy and as initial therapy in those who require large reductions in diastolic blood pressure or systolic blood pressure to achieve goal blood pressure.

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Related in: MedlinePlus

Mean change in (a) seated diastolic blood pressure (DBP) (mmHg) (b) systolic blood pressure (SBP) (mmHg) from study baseline at week 4 (LOCF) and (c) patients achieving target blood pressure by dose group in the treat-to-target cohort.Abbreviations: HCTZ, hydrochlorothiazide; OLM, olmesartan medoxomil.
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f2-vhrm-4-1237: Mean change in (a) seated diastolic blood pressure (DBP) (mmHg) (b) systolic blood pressure (SBP) (mmHg) from study baseline at week 4 (LOCF) and (c) patients achieving target blood pressure by dose group in the treat-to-target cohort.Abbreviations: HCTZ, hydrochlorothiazide; OLM, olmesartan medoxomil.

Mentions: In a further analysis of the data derived from this study, mean changes from treatment baseline were calculated for DBP and SBP using observations before each step in the algorithm, and are demonstrated in Figure 2a and b (Daiichi-Sankyo, Integrated Summary of Efficacy, data on file). Further analysis examining the proportion of patients achieving the target blood pressure of ≤140/≤90 mmHg showed that at the end of the second step, when the maximal dose of olmesartan was being used, 57.5% of the 198 patients had reached target. At the end of the 4th treatment step, when the maximum doses of olmesartan and HCTZ were being used, the proportion of patients who had reached the ≤140/≤90 mmHg target was 82.1%. When the analysis used the more stringent target of ≤130/≤85 mmHg, the proportion of patients who had reached target at the end of the second and fourth steps was 33.0 and 65.4%, respectively (Figure 2c) (Daiichi-Sankyo, Integrated Summary of Efficacy, data on file). The addition of amlodipine produced further reductions in BP so that by the end of the sixth treatment step (study end), when the maximum dose of all three agents was being used, the proportion of patients achieving the ≤140/≤90 and ≤130/≤85 mmHg goals was 92.7 and 83.8%, respectively.


Clinical efficacy and safety of olmesartan/hydrochlorothiazide combination therapy in patients with essential hypertension.

Ruilope LM - Vasc Health Risk Manag (2008)

Mean change in (a) seated diastolic blood pressure (DBP) (mmHg) (b) systolic blood pressure (SBP) (mmHg) from study baseline at week 4 (LOCF) and (c) patients achieving target blood pressure by dose group in the treat-to-target cohort.Abbreviations: HCTZ, hydrochlorothiazide; OLM, olmesartan medoxomil.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2663442&req=5

f2-vhrm-4-1237: Mean change in (a) seated diastolic blood pressure (DBP) (mmHg) (b) systolic blood pressure (SBP) (mmHg) from study baseline at week 4 (LOCF) and (c) patients achieving target blood pressure by dose group in the treat-to-target cohort.Abbreviations: HCTZ, hydrochlorothiazide; OLM, olmesartan medoxomil.
Mentions: In a further analysis of the data derived from this study, mean changes from treatment baseline were calculated for DBP and SBP using observations before each step in the algorithm, and are demonstrated in Figure 2a and b (Daiichi-Sankyo, Integrated Summary of Efficacy, data on file). Further analysis examining the proportion of patients achieving the target blood pressure of ≤140/≤90 mmHg showed that at the end of the second step, when the maximal dose of olmesartan was being used, 57.5% of the 198 patients had reached target. At the end of the 4th treatment step, when the maximum doses of olmesartan and HCTZ were being used, the proportion of patients who had reached the ≤140/≤90 mmHg target was 82.1%. When the analysis used the more stringent target of ≤130/≤85 mmHg, the proportion of patients who had reached target at the end of the second and fourth steps was 33.0 and 65.4%, respectively (Figure 2c) (Daiichi-Sankyo, Integrated Summary of Efficacy, data on file). The addition of amlodipine produced further reductions in BP so that by the end of the sixth treatment step (study end), when the maximum dose of all three agents was being used, the proportion of patients achieving the ≤140/≤90 and ≤130/≤85 mmHg goals was 92.7 and 83.8%, respectively.

Bottom Line: Guidelines recommend that many patients will require two or more antihypertensive agents from different classes.Combining an angiotensin II receptor blocker (ARB) with hydrochlorothiazide (HCTZ) has been shown in clinical studies to increase the antihypertensive efficacy of both agents compared with either agent alone.Thus olmesartan/HCTZ is a well-tolerated option for patients who fail to respond to monotherapy and as initial therapy in those who require large reductions in diastolic blood pressure or systolic blood pressure to achieve goal blood pressure.

View Article: PubMed Central - PubMed

Affiliation: Unidad de Hipertensión, Hospital 12 de Octubre, Madrid, Spain. ruilope@ad-hocbox.com

ABSTRACT
Hypertension is a major risk factor for cardiovascular disease that contributes to the premature death of millions of people each year, and identification and treatment of hypertension continues to be a challenge. Guidelines recommend that many patients will require two or more antihypertensive agents from different classes. Combining an angiotensin II receptor blocker (ARB) with hydrochlorothiazide (HCTZ) has been shown in clinical studies to increase the antihypertensive efficacy of both agents compared with either agent alone. This review covers several clinical trials and aims to examine several aspects of the efficacy of the combination of olmesartan and HCTZ, including dose-responsiveness, long-term efficacy, goal rate achievement, and efficacy in patients with moderate to severe hypertension. The results presented here demonstrate that olmesartan is effective when added to HCTZ monotherapy or when HCTZ is added to olmesartan monotherapy, both over the short and long term. Moderate to severe hypertension responds well to olmesartan/HCTZ combination therapy, and the great majority of patients are able to achieve recommended blood pressure targets. Thus olmesartan/HCTZ is a well-tolerated option for patients who fail to respond to monotherapy and as initial therapy in those who require large reductions in diastolic blood pressure or systolic blood pressure to achieve goal blood pressure.

Show MeSH
Related in: MedlinePlus