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Adding HCTZ to olmesartan therapy improves 24-hour blood pressure control and response rates in patients with mild-to-moderate hypertension
Erweiterung der Olmesartan-Therapie um HCTZ verbessert die 24h- Blutdruckwerte und Ansprechraten
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Veröffentlicht: | 10. August 2005 |
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Objective: To compare the effects of adding hydrochlorothiazide (HCTZ; 12.5 mg or 25 mg) or placebo to olmesartan medoxomil 20 mg on blood pressure in patients whose essential hypertension was inadequately controlled on olmesartan monotherapy.
Design: Partially-randomised, placebo-controlled, multi-centre, prospective study.
Setting: Primary care investigational centres.
Patients: Male and female patients >=18 years with mean sitting diastolic BP (dBP) of 100-115 mmHg, mean sitting systolic (sBP) greater than 150 mmHg, mean 24-hour dBP of at least 84 mmHg, and at least 30% of dBP daytime readings >90 mmHg.
Interventions: Four weeks of initial single-blind treatment with olmesartan medoxomil 20 mg once daily, followed in non-responders by 8 weeks of randomised double-blind treatment with placebo or HCTZ (12.5 mg or 25 mg) once-daily added to olmesartan therapy.
Results: The primary efficacy parameter, mean daytime dBP, decreased significantly more with HCTZ 25 mg (p=0.0012) than with placebo. Relative to placebo, significantly greater decreases in mean 24-hour dBP and sBP were produced by the addition of HCTZ 12.5 mg (-1.9 mmHg, p=0.0167 and -3.9 mmHg, p=0.0018, respectively) and 25 mg (-3.7 mmHg and -7.4 mmHg respectively, p <0.0001 for both). Response rates (mean daytime dBP assessed by ABPM £85 mmHg) approximately doubled following the addition of HCTZ (12.5 mg = 57.6% and 25 mg =69.5%). All treatments were well tolerated.
Conclusion: For patients whose blood pressure cannot be adequately controlled with olmesartan medoxomil monotherapy, the addition of HCTZ provides significant additional 24-h blood pressure-lowering efficacy in patients without affecting tolerability.