Effectiveness of initiating treatment with valsartan/hydrochlorothiazide in patients with stage-1 or stage-2 hypertension

D. H. Zappe, B. F. Palmer, D. A. Calhoun, D. Purkayastha, R. Samuel, K. A. Jamerson

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)483-491
Number of pages9
JournalJournal of Human Hypertension
Volume24
Issue number7
DOIs
StatePublished - Jul 2010

Fingerprint

Valsartan
Hydrochlorothiazide
Hypertension
Blood Pressure

Keywords

  • initial combination therapy
  • valsartan
  • valsartan/hydrochlorothiazide

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Effectiveness of initiating treatment with valsartan/hydrochlorothiazide in patients with stage-1 or stage-2 hypertension. / Zappe, D. H.; Palmer, B. F.; Calhoun, D. A.; Purkayastha, D.; Samuel, R.; Jamerson, K. A.

In: Journal of Human Hypertension, Vol. 24, No. 7, 07.2010, p. 483-491.

Research output: Contribution to journalArticle

Zappe, D. H. ; Palmer, B. F. ; Calhoun, D. A. ; Purkayastha, D. ; Samuel, R. ; Jamerson, K. A. / Effectiveness of initiating treatment with valsartan/hydrochlorothiazide in patients with stage-1 or stage-2 hypertension. In: Journal of Human Hypertension. 2010 ; Vol. 24, No. 7. pp. 483-491.
@article{c138a15a74904538b07cd3ebc20f95c2,
title = "Effectiveness of initiating treatment with valsartan/hydrochlorothiazide in patients with stage-1 or stage-2 hypertension",
abstract = "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.",
keywords = "initial combination therapy, valsartan, valsartan/hydrochlorothiazide",
author = "Zappe, {D. H.} and Palmer, {B. F.} and Calhoun, {D. A.} and D. Purkayastha and R. Samuel and Jamerson, {K. A.}",
year = "2010",
month = "7",
doi = "10.1038/jhh.2009.90",
language = "English (US)",
volume = "24",
pages = "483--491",
journal = "Journal of Human Hypertension",
issn = "0950-9240",
publisher = "Nature Publishing Group",
number = "7",

}

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.

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

UR - http://www.scopus.com/inward/record.url?scp=77953809954&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77953809954&partnerID=8YFLogxK

U2 - 10.1038/jhh.2009.90

DO - 10.1038/jhh.2009.90

M3 - Article

C2 - 20010618

AN - SCOPUS:77953809954

VL - 24

SP - 483

EP - 491

JO - Journal of Human Hypertension

JF - Journal of Human Hypertension

SN - 0950-9240

IS - 7

ER -