Effectiveness of initiating treatment with valsartan hydrochlorothiazide in patients with stage-1 or stage-2 hypertension
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...
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| Veröffentlicht in: | Journal of human hypertension 2010-07, Vol.24 (7), p.483-491 |
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| creator | Zappe, D H Palmer, B F Calhoun, D A Purkayastha, D Samuel, R Jamerson, K A |
| description | 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 |
| doi_str_mv | 10.1038/jhh.2009.90 |
| format | Article |
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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±8 mm Hg) compared with V-low (46%, −21.2±13/−11.4±8 mm Hg,
P
<0.0001) or V-high (51%, −24.0±13/−12.0±10 mm Hg,
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.</description><identifier>ISSN: 0950-9240</identifier><identifier>EISSN: 1476-5527</identifier><identifier>DOI: 10.1038/jhh.2009.90</identifier><identifier>PMID: 20010618</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject><![CDATA[Adult ; Aged ; Antihypertensive agents ; Antihypertensive Agents - administration & dosage ; Antihypertensive Agents - adverse effects ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiovascular system ; Complications and side effects ; Diagnosis ; Dosage and administration ; Drug therapy ; Drug Therapy, Combination ; Epidemiology ; Female ; Health Administration ; Humans ; Hydrochlorothiazide ; Hydrochlorothiazide - administration & dosage ; Hydrochlorothiazide - adverse effects ; Hypertension ; Hypertension - drug therapy ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Original ; original-article ; Patient outcomes ; Pharmacology. Drug treatments ; Public Health ; Tetrazoles - administration & dosage ; Tetrazoles - adverse effects ; Treatment Outcome ; Valine - administration & dosage ; Valine - adverse effects ; Valine - analogs & derivatives ; Valsartan]]></subject><ispartof>Journal of human hypertension, 2010-07, Vol.24 (7), p.483-491</ispartof><rights>The Author(s) 2010</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2010 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Jul 2010</rights><rights>Copyright © 2010 Macmillan Publishers Limited 2010 Macmillan Publishers Limited</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c596t-2e8761ad99c7b51ef5bd024afe41c58142285826e83e666184f5621ca3c40a23</citedby><cites>FETCH-LOGICAL-c596t-2e8761ad99c7b51ef5bd024afe41c58142285826e83e666184f5621ca3c40a23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,782,786,887,27931,27932</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22879357$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20010618$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zappe, D H</creatorcontrib><creatorcontrib>Palmer, B F</creatorcontrib><creatorcontrib>Calhoun, D A</creatorcontrib><creatorcontrib>Purkayastha, D</creatorcontrib><creatorcontrib>Samuel, R</creatorcontrib><creatorcontrib>Jamerson, K A</creatorcontrib><title>Effectiveness of initiating treatment with valsartan hydrochlorothiazide in patients with stage-1 or stage-2 hypertension</title><title>Journal of human hypertension</title><addtitle>J Hum Hypertens</addtitle><addtitle>J Hum Hypertens</addtitle><description>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±8 mm Hg) compared with V-low (46%, −21.2±13/−11.4±8 mm Hg,
P
<0.0001) or V-high (51%, −24.0±13/−12.0±10 mm Hg,
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.</description><subject>Adult</subject><subject>Aged</subject><subject>Antihypertensive agents</subject><subject>Antihypertensive Agents - administration & dosage</subject><subject>Antihypertensive Agents - adverse effects</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular system</subject><subject>Complications and side effects</subject><subject>Diagnosis</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Drug Therapy, Combination</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health Administration</subject><subject>Humans</subject><subject>Hydrochlorothiazide</subject><subject>Hydrochlorothiazide - administration & dosage</subject><subject>Hydrochlorothiazide - adverse effects</subject><subject>Hypertension</subject><subject>Hypertension - drug therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original</subject><subject>original-article</subject><subject>Patient outcomes</subject><subject>Pharmacology. Drug treatments</subject><subject>Public Health</subject><subject>Tetrazoles - administration & dosage</subject><subject>Tetrazoles - adverse effects</subject><subject>Treatment Outcome</subject><subject>Valine - administration & dosage</subject><subject>Valine - adverse effects</subject><subject>Valine - analogs & derivatives</subject><subject>Valsartan</subject><issn>0950-9240</issn><issn>1476-5527</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptks2P0zAQxSMEYsvCiTtEILhAiu3EiX1BWq2WD2klLnu3XGfcuErtYrtF5a9nqpTuVlr5YMvze8_PoymK15TMKanFl9UwzBkhci7Jk2JGm66tOGfd02JGJCeVZA25KF6ktCLkUBTPiwvEKWmpmBX7G2vBZLcDDymVwZbOu-x0dn5Z5gg6r8Hn8o_LQ7nTY9Ixa18O-z4GM4whhjw4_df1gLpygzKk04SnrJdQ0TLE45GhbgMxg08u-JfFM4uG8Oq4XxZ3327urn9Ut7--_7y-uq0Ml22uGIiupbqX0nQLTsHyRU9Yoy001HBBG8YEF6wFUUPb4p8ay1tGja5NQzSrL4uvk-1mu1hDbzBf1KPaRLfWca-Cduq84t2glmGnmJCC1xIN3h0NYvi9hZTVKmyjx8iKY9dbyboaofcTtNQjKOdtQC-zdsmoK8Zkh7G6Q5b5IxSuHtbOBA_W4f2Z4OMDwQB6zEMK4zZj_9I5-GkCTQwpRbCnD1KiDlOicErUYUqUJEi_ediTE_t_LBD4cAR0Mnq0UXvj0j3HRCdr3iH3eeISlvwS4n1vHn_37YR7nbcRTn7IHBAk_gFx6d8X</recordid><startdate>20100701</startdate><enddate>20100701</enddate><creator>Zappe, D H</creator><creator>Palmer, B F</creator><creator>Calhoun, D A</creator><creator>Purkayastha, D</creator><creator>Samuel, R</creator><creator>Jamerson, K A</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>5PM</scope></search><sort><creationdate>20100701</creationdate><title>Effectiveness of initiating treatment with valsartan hydrochlorothiazide in patients with stage-1 or stage-2 hypertension</title><author>Zappe, D H ; Palmer, B F ; Calhoun, D A ; Purkayastha, D ; Samuel, R ; Jamerson, K A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c596t-2e8761ad99c7b51ef5bd024afe41c58142285826e83e666184f5621ca3c40a23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Antihypertensive agents</topic><topic>Antihypertensive Agents - administration & dosage</topic><topic>Antihypertensive Agents - adverse effects</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular system</topic><topic>Complications and side effects</topic><topic>Diagnosis</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Drug Therapy, Combination</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Health Administration</topic><topic>Humans</topic><topic>Hydrochlorothiazide</topic><topic>Hydrochlorothiazide - administration & dosage</topic><topic>Hydrochlorothiazide - adverse effects</topic><topic>Hypertension</topic><topic>Hypertension - drug therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original</topic><topic>original-article</topic><topic>Patient outcomes</topic><topic>Pharmacology. Drug treatments</topic><topic>Public Health</topic><topic>Tetrazoles - administration & dosage</topic><topic>Tetrazoles - adverse effects</topic><topic>Treatment Outcome</topic><topic>Valine - administration & dosage</topic><topic>Valine - adverse effects</topic><topic>Valine - analogs & derivatives</topic><topic>Valsartan</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zappe, D H</creatorcontrib><creatorcontrib>Palmer, B F</creatorcontrib><creatorcontrib>Calhoun, D A</creatorcontrib><creatorcontrib>Purkayastha, D</creatorcontrib><creatorcontrib>Samuel, R</creatorcontrib><creatorcontrib>Jamerson, K A</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of human hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zappe, D H</au><au>Palmer, B F</au><au>Calhoun, D A</au><au>Purkayastha, D</au><au>Samuel, R</au><au>Jamerson, K A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of initiating treatment with valsartan hydrochlorothiazide in patients with stage-1 or stage-2 hypertension</atitle><jtitle>Journal of human hypertension</jtitle><stitle>J Hum Hypertens</stitle><addtitle>J Hum Hypertens</addtitle><date>2010-07-01</date><risdate>2010</risdate><volume>24</volume><issue>7</issue><spage>483</spage><epage>491</epage><pages>483-491</pages><issn>0950-9240</issn><eissn>1476-5527</eissn><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±8 mm Hg) compared with V-low (46%, −21.2±13/−11.4±8 mm Hg,
P
<0.0001) or V-high (51%, −24.0±13/−12.0±10 mm Hg,
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.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>20010618</pmid><doi>10.1038/jhh.2009.90</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of human hypertension, 2010-07, Vol.24 (7), p.483-491 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aged Antihypertensive agents Antihypertensive Agents - administration & dosage Antihypertensive Agents - adverse effects Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cardiovascular system Complications and side effects Diagnosis Dosage and administration Drug therapy Drug Therapy, Combination Epidemiology Female Health Administration Humans Hydrochlorothiazide Hydrochlorothiazide - administration & dosage Hydrochlorothiazide - adverse effects Hypertension Hypertension - drug therapy Male Medical sciences Medicine Medicine & Public Health Middle Aged Original original-article Patient outcomes Pharmacology. Drug treatments Public Health Tetrazoles - administration & dosage Tetrazoles - adverse effects Treatment Outcome Valine - administration & dosage Valine - adverse effects Valine - analogs & derivatives Valsartan |
| title | Effectiveness of initiating treatment with valsartan hydrochlorothiazide in patients with stage-1 or stage-2 hypertension |
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