Effects of high dose olmesartan medoxomil plus hydrochlorothiazide on blood pressure control in patients with grade 2 and grade 3 hypertension

High dose (40 mg) olmesartan medoxomil (OM) blocks the angiotensin II receptor, significantly reducing blood pressure (BP). Adding hydrochlorothiazide (HCTZ) to OM increases efficacy, but has not been evaluated in patients inadequately controlled by OM 40 mg. Patients with grade 2 and grade 3 hypert...

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Veröffentlicht in:Journal of human hypertension 2011-09, Vol.25 (9), p.565-574
Hauptverfasser: Rump, L C, Girerd, X, Sellin, L, Stegbauer, J
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container_title Journal of human hypertension
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creator Rump, L C
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Stegbauer, J
description High dose (40 mg) olmesartan medoxomil (OM) blocks the angiotensin II receptor, significantly reducing blood pressure (BP). Adding hydrochlorothiazide (HCTZ) to OM increases efficacy, but has not been evaluated in patients inadequately controlled by OM 40 mg. Patients with grade 2 and grade 3 hypertension with inadequately controlled BP (seated diastolic blood pressure [SeDBP] 90–115 mm Hg and seated systolic blood pressure [SeSBP] 140–180 mm Hg, plus ambulatory BP criteria) after 8 weeks of OM 40 mg open-label treatment were randomized to 8 weeks of double-blind treatment with OM/HCTZ 40/25 ( n =140), 40/12.5 ( n =278), 20/12.5 mg ( n =280) or OM 40 mg ( n =274). Treatment with OM/HCTZ 40/25 mg and 40/12.5 mg significantly reduced SeDBP (−5.3 and −3.4 mm Hg, respectively), and SeSBP (−7.4 and −5.2 mm Hg, respectively), vs OM 40 mg monotherapy ( P
doi_str_mv 10.1038/jhh.2010.105
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Adding hydrochlorothiazide (HCTZ) to OM increases efficacy, but has not been evaluated in patients inadequately controlled by OM 40 mg. Patients with grade 2 and grade 3 hypertension with inadequately controlled BP (seated diastolic blood pressure [SeDBP] 90–115 mm Hg and seated systolic blood pressure [SeSBP] 140–180 mm Hg, plus ambulatory BP criteria) after 8 weeks of OM 40 mg open-label treatment were randomized to 8 weeks of double-blind treatment with OM/HCTZ 40/25 ( n =140), 40/12.5 ( n =278), 20/12.5 mg ( n =280) or OM 40 mg ( n =274). Treatment with OM/HCTZ 40/25 mg and 40/12.5 mg significantly reduced SeDBP (−5.3 and −3.4 mm Hg, respectively), and SeSBP (−7.4 and −5.2 mm Hg, respectively), vs OM 40 mg monotherapy ( P &lt;0.0001 for each) in patients inadequately controlled on OM 40 mg alone. OM/HCTZ 40/12.5 mg reduced SeSBP significantly more than OM/HCTZ 20/12.5 mg (−2.6 mm Hg, P =0.0255), and also produced a further reduction in SeDBP vs the lower dose. All treatments were well tolerated, with similar low proportions of patients reporting treatment-emergent adverse events in all treatment groups. In conclusion, adding HCTZ to OM 40 mg significantly improves BP reductions and target BP rates in harder-to-treat patients and a clear dose-response was observed for efficacy.</description><identifier>ISSN: 0950-9240</identifier><identifier>EISSN: 1476-5527</identifier><identifier>DOI: 10.1038/jhh.2010.105</identifier><identifier>PMID: 21107435</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/92/436/2388 ; 692/699/75/243 ; 692/700/565/1436/1437 ; Adult ; Aged ; Angiotensin ; Angiotensin II ; Antihypertensive Agents - administration &amp; dosage ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood pressure ; Blood Pressure - drug effects ; Cardiology. Vascular system ; Clinical manifestations. Epidemiology. 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Adding hydrochlorothiazide (HCTZ) to OM increases efficacy, but has not been evaluated in patients inadequately controlled by OM 40 mg. Patients with grade 2 and grade 3 hypertension with inadequately controlled BP (seated diastolic blood pressure [SeDBP] 90–115 mm Hg and seated systolic blood pressure [SeSBP] 140–180 mm Hg, plus ambulatory BP criteria) after 8 weeks of OM 40 mg open-label treatment were randomized to 8 weeks of double-blind treatment with OM/HCTZ 40/25 ( n =140), 40/12.5 ( n =278), 20/12.5 mg ( n =280) or OM 40 mg ( n =274). Treatment with OM/HCTZ 40/25 mg and 40/12.5 mg significantly reduced SeDBP (−5.3 and −3.4 mm Hg, respectively), and SeSBP (−7.4 and −5.2 mm Hg, respectively), vs OM 40 mg monotherapy ( P &lt;0.0001 for each) in patients inadequately controlled on OM 40 mg alone. OM/HCTZ 40/12.5 mg reduced SeSBP significantly more than OM/HCTZ 20/12.5 mg (−2.6 mm Hg, P =0.0255), and also produced a further reduction in SeDBP vs the lower dose. 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Adding hydrochlorothiazide (HCTZ) to OM increases efficacy, but has not been evaluated in patients inadequately controlled by OM 40 mg. Patients with grade 2 and grade 3 hypertension with inadequately controlled BP (seated diastolic blood pressure [SeDBP] 90–115 mm Hg and seated systolic blood pressure [SeSBP] 140–180 mm Hg, plus ambulatory BP criteria) after 8 weeks of OM 40 mg open-label treatment were randomized to 8 weeks of double-blind treatment with OM/HCTZ 40/25 ( n =140), 40/12.5 ( n =278), 20/12.5 mg ( n =280) or OM 40 mg ( n =274). Treatment with OM/HCTZ 40/25 mg and 40/12.5 mg significantly reduced SeDBP (−5.3 and −3.4 mm Hg, respectively), and SeSBP (−7.4 and −5.2 mm Hg, respectively), vs OM 40 mg monotherapy ( P &lt;0.0001 for each) in patients inadequately controlled on OM 40 mg alone. OM/HCTZ 40/12.5 mg reduced SeSBP significantly more than OM/HCTZ 20/12.5 mg (−2.6 mm Hg, P =0.0255), and also produced a further reduction in SeDBP vs the lower dose. All treatments were well tolerated, with similar low proportions of patients reporting treatment-emergent adverse events in all treatment groups. In conclusion, adding HCTZ to OM 40 mg significantly improves BP reductions and target BP rates in harder-to-treat patients and a clear dose-response was observed for efficacy.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>21107435</pmid><doi>10.1038/jhh.2010.105</doi><tpages>10</tpages></addata></record>
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subjects 631/92/436/2388
692/699/75/243
692/700/565/1436/1437
Adult
Aged
Angiotensin
Angiotensin II
Antihypertensive Agents - administration & dosage
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood pressure
Blood Pressure - drug effects
Cardiology. Vascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Control
Dosage and administration
Double-Blind Method
Drug therapy
Drug Therapy, Combination
Epidemiology
Female
Health Administration
Humans
Hydrochlorothiazide
Hydrochlorothiazide - administration & dosage
Hydrochlorothiazide - adverse effects
Hypertension
Hypertension - drug therapy
Hypertension - physiopathology
Imidazoles - administration & dosage
Imidazoles - adverse effects
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Olmesartan Medoxomil
original-article
Patient outcomes
Patients
Public Health
Tetrazoles - administration & dosage
Tetrazoles - adverse effects
title Effects of high dose olmesartan medoxomil plus hydrochlorothiazide on blood pressure control in patients with grade 2 and grade 3 hypertension
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