Efficacy and safety of olmesartan medoxomil plus amlodipine in age, gender and hypertension severity defined subgroups of hypertensive patients

Abstract

Effective antihypertensive therapy is crucial for preventing cardiovascular events; however, blood pressure (BP) control rates remain poor. The objective of this analysis was to determine the efficacy of olmesartan/ amlodipine in age, severity and gender-based subgroups of patients with moderate-to-severe hypertension uncontrolled by amlodipine monotherapy. Patients with uncontrolled BP after 8 weeks' amlodipine 5 mg monotherapy (n ¼ 755) were randomized to continue amlodipine 5 mg or receive olmesartan (10-40 mg) plus amlodipine 5 mg for 8 weeks. Patients whose BP remained suboptimal were uptitrated to olmesartan/ amlodipine 20/5, 40/5 or 40/10 mg. Changes in BP and numbers of controlled patients were calculated separately to assess efficacy in patients aged o65 or X65 years, in those with moderate or severe hypertension, and in males and females. The antihypertensive effects of olmesartan/amlodipine were similar in patients aged o65 and X65 years of age. Compared with patients with moderate hypertension at baseline, those with severe hypertension tended to show higher decreases in BP, but achieved lower goal rates despite this. Females showed larger mean reductions in diastolic (1.61 mm Hg; P ¼ 0.003) and systolic BP (1.72 mm Hg; P ¼ 0.053) than males, independent of age and dose. This gender difference appeared to be higher and more consistent across dose groups for patients o50 years of age, but the difference in the pattern between both age groups was not statistically significant (P ¼ 0.1526). These results suggest that olmesartan/amlodipine is effective and safe in a wide range of patients, regardless of age or hypertension severity. Small differences in responsiveness between females and males may exist, which require further investigation.

Efficacy and Tolerability of Triple‐Combination Therapy With Olmesartan, Amlodipine, and Hydrochlorothiazide: A Subgroup Analysis of Patients Stratified by Hypertension Severity, Age, Sex, and Obesity

“…This effect is almost certainly related to the higher baseline BP levels in the severe hypertension group, and has been observed in previous studies. 19,20 The impact of treatment on hypertension severity was also examined in a post-hoc analysis based on the ESH's classification system for BP/hypertension. This analysis revealed that, at baseline, the majority of patients had met the criteria for grade 2 or 3 hypertension.…”

Age‐ and Sex‐Related Differences in Efficacy With an Angiotensin II Receptor Blocker and a Calcium Channel Blocker in Asian Hypertensive Patients

“…According to a report by Schmieder and colleagues on the effects of CCB (amlodipine) monotherapy and CCB/ARB (olmesartan) combination therapy between the sexes, results demonstrated that a greater BP‐lowering effect on both SBP and DBP was observed in women compared with men. It has also been reported that this sex difference decreased as the dose of the ARB increased.…”

Combined Olmesartan, Amlodipine, and Hydrochlorothiazide Therapy in Randomized Patients with Hypertension: A Subgroup Analysis of the TRINITY Study by Age

“…The incidence of hypotension was similar across age groups (<65 years of age: 0.4 %; ≥65 years of age: 0.7 %); however, more participants ≥75 years of age (4.2 %) discontinued their study medication due to an adverse event compared with participants <65 years of age (2.2 %) and ≥65 years of age (2.9 %). OM either as monotherapy or in combination with HCTZ and/or AML is an effective and safe treatment for hypertension in a broad range of patients, including the elderly [32–36]. In one study, 52–67 % of study participants ≥65 years of age receiving OM/HCTZ combination therapy achieved the SeBP goal of <140/90 mmHg, while in another study, 61 % of participants ≥65 years of age receiving OM/AML combination therapy, with or without HCTZ, achieved the SeBP goal of <140/90 mmHg (<130/80 mmHg in participants with diabetes) [32, 34].…”