Achieving blood pressure goal: initial therapy with valsartan/hydrochlorothiazide combination compared with monotherapy

Abstract

The benefits of valsartan (Val)/hydrochlorothiazide (HCTZ) combination as initial treatment for hypertension were evaluated in a post hoc analysis of an 8-week, doubleblind, placebo-controlled, parallel-group trial. The highest dose of Val/HCTZ combination (320/25 mg), component monotherapies (Val 320 mg, HCTZ 25 mg) and placebo were selected for this analysis (N ¼ 675, 52.1% men, 68.6% Caucasians, mean age 52.9 years, baseline blood pressure (BP) 150.6/99.1 mm Hg). As soon as 2 weeks after initiation of active therapy, greater BP control rates were observed with Val/HCTZ (320/25 mg) compared with Val (320 mg), HCTZ (25 mg) and placebo. Similar results were observed in subgroups of patients with stage 1 and stage 2 hypertension, as well as in diabetic patients. As baseline BP increased, the probability of achieving mean sitting systolic BP (o140 and o130 mm Hg) and mean sitting diastolic BP control (o90 and o80 mm Hg), determined using a logistic regression model, decreased with all treatments. However, at all levels of baseline BP, the probability of achieving BP control was greater with Val/HCTZ combination. The Val/HCTZ combination was well tolerated with overall incidence of adverse events similar to that observed with monotherapy and placebo. These results support the use of Val/HCTZ combination as initial therapy in hypertensive patients unlikely to achieve BP control with a single agent.

Assessment of medication adherence among hypertensive patients: a cross-sectional study

“…These findings are consistent with the studies done by Salanitro et al, Zachariah et al and Weinberger et al which have documented 40%-70% of patients having uncontrolled blood pressure. [40][41][42] A study by Elzubier et al using pill counting method documented, 61.6% had controlled blood pressure while 38.4 had uncontrolled and found that 92% compliant patients had controlled blood pressure in comparison to noncompliant patients. Major reason for noncompliance was "not able to afford/buy medicines".…”

Efficacy and safety of valsartan compared to enalapril in hypertensive children

“…Valsartan, a well known ARB, has proven efficacy and safety when used either as monotherapy or in combination to treat hypertension in adults [18][19][20]. A doseresponse study in children aged 6-16 years demonstrated that valsartan was efficacious and well tolerated in doses ranging from 10 to 160 mg [21].…”

Efficacy and safety of valsartan in hypertensive children 6 months to 5 years of age

“…Valsartan is an ARB that has proven efficacy and safety when used either as monotherapy or in combination to treat hypertension in adults [14][15][16][17]. This ARB has also demonstrated efficacy and safety in doses ranging from 10 to 160 mg in children aged 6-16 years [18].…”