Journal
JOURNAL OF CLINICAL HYPERTENSION
Volume 13, Issue 8, Pages 588-597Publisher
WILEY
DOI: 10.1111/j.1751-7176.2011.00492.x
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Funding
- Novartis Pharmaceuticals Corporation
- Atri-tech
- St Jude Medical
- Roche
- AstraZeneca Pharmaceuticals LP
- Merck Co, Inc
- Pfizer Inc
- Forest Labs
- Daiichi Sankyo
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This study compared the efficacy and safety of combination angiotensin-receptor blocker (ARB)/calcium-channel blocker (CCB) with hydrochlorothiazide (valsartan/amlodipine/HCTZ 160/5/25 mg) vs maximal available combination doses of an ARB with HCTZ (losartan/HCTZ 100/25 mg) in the management of stage 2 hypertension. After 1 to 2 weeks of antihypertensive drug washout, patients with a mean sitting systolic blood pressure (MSSBP) of >= 160 mm Hg and < 200 mm Hg were randomized to valsartan/amlodipine 160/5 mg (n=241) or losartan 100 mg (n=247). At week 3, HCTZ 25 mg was added to both treatments. The primary end point, reduction in MSSBP from baseline to week 6, was significantly greater in the valsartan/amlodipine group than in the losartan group (least-squares [LS] mean change, -31.8 mm Hg vs -26.4 mm Hg; P <.001). Additional reductions occurred after titrating to 320/10/25 mg at week 6 in the valsartan/amlodipine group and switching from losartan/HCTZ to valsartan/amlodipine/HCTZ (week 6, 160/5/25 mg; week 9, 320/10/25 mg) in the losartan group. Achievement of blood pressure < 140/90 mm Hg also favored the valsartan/amlodipine group. Dizziness was the only adverse event reported in > 5% of patients (5.4% valsartan/amlodipine group, 3.6% losartan group). Moderate doses of an ARB/CCB combination with HCTZ reduced blood pressure more effectively than the maximal dose of an ARB with HCTZ. J Clin Hypertens (Greenwich). 2011; 13: 588-597. (C)2011 Wiley Periodicals, Inc.
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