Efficacy and Safety of Treating Stage 2 Systolic Hypertension With Olmesartan and Olmesartan/HCTZ: Results of an Open‐Label Titration Study

Izzo, Joseph L.; Neutel, Joel M.; Silfani, Tonous; Dubiel, Robert; Walker, Findlay

doi:10.1111/j.1524-6175x.2007.5713.x

Cited by 39 publications

(37 citation statements)

References 39 publications

(48 reference statements)

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“…negative relationship to CHD risk) with increasing age. [16] The results of the present analysis are consistent with the study of Izzo and colleagues [14] in patients with stage 2 systolic hypertension, which demonstrated that olmesartan medoxomil 20 mg day reduced mean SBP by 16.9 mmHg, with further dose-dependent decreases in mean SBP to a maximum of 34.5 mmHg with olmesartan medoxomil HCTZ 40 25 mg per day. In addition, the proportion of patients that achieved an SBP target of <140 mmHg after 12 weeks' treatment in the Izzo et al [14] study is virtually identical to that in the present analysis (75.1% vs 74.8%, respectively).…”

Section: Discussionsupporting

confidence: 94%

“…[2] Achieving BP goal in a majority of patients is a realistic objective even in more difficult to treat patients. Izzo et al [14] demonstrated that the use of an olmesartan medoxomil-based treatment algorithm reduced SBP by 35 mmHg in patients with stage 2 hypertension and enabled 70% to achieve a BP goal of <140 90 mmHg. More recently, the BENIFORCE (Benicar Efficacy: New Investigative Findings show Olmesartan medoxomil safely and effectively Reduces blood pressure Compared with placebo in a clinical Evaluation of patients with stage 1 and stage 2 hypertension) study was conducted to evaluate the efficacy of olmesartan medoxomil in patients stratified by hypertension severity.…”

Section: Introductionmentioning

confidence: 98%

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Effect of an Olmesartan Medoxomil-Based Treatment Algorithm on Systolic Blood Pressure in Patients with Stage 1 or 2 Hypertension

Kereiakes

Maa

Shojaee

et al. 2010

American Journal Cardiovascular Drugs

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 98%

Effect of an Olmesartan Medoxomil-Based Treatment Algorithm on Systolic Blood Pressure in Patients with Stage 1 or 2 Hypertension

Kereiakes

Maa

Shojaee

et al. 2010

American Journal Cardiovascular Drugs

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“…One open-label study of olmesartan/ hydrochlorothiazide in stage 2 systolic hypertension (SBP Ն160.0 mm Hg) showed a 34.5-mm Hg reduction in SBP with the 40/25-mg dose, comparable to the 37.1-mm Hg SBP reduction in the olmesartan/hydrochlorothiazide arm of the current study with the same doses. 24 Although a randomized direct comparison of chlorthalidone and hydrochlorothiazide for cardiovascular outcomes is not available, the totality of evidence suggests that chlorthalidone reduces cardiovascular risk more effectively than hydrochlorothiazide at equivalent doses. In a retrospective observational cohort study from the Multiple Risk Factor Intervention Trial, patients treated with chlorthalidone had a 21% lower risk of cardiovascular events than patients treated with hydrochlorothiazide.…”

Section: Discussionmentioning

confidence: 99%

Azilsartan Medoxomil Plus Chlorthalidone Reduces Blood Pressure More Effectively Than Olmesartan Plus Hydrochlorothiazide in Stage 2 Systolic Hypertension

et al. 2012

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Abstract-Azilsartan medoxomil, an effective, long-acting angiotensin II receptor blocker, is a new treatment for hypertension that is also being developed in fixed-dose combinations with chlorthalidone, a potent, long-acting thiazide-like diuretic. We compared once-daily fixed-dose combinations of azilsartan medoxomil/chlorthalidone force titrated to a high dose of either 40/25 mg or 80/25 mg with a fixed-dose combination of the angiotensin II receptor blocker olmesartan medoxomil plus the thiazide diuretic hydrochlorothiazide force titrated to 40/25 mg. The design was a randomized, 3-arm, double-blind, 12-week study of 1071 participants with baseline clinic systolic blood pressure 160 to 190 mm Hg and diastolic blood pressure Յ119 mm Hg. Patients had a mean age of 57 years; 59% were men, 73% were white, and 22% were black. At baseline, mean clinic blood pressure was 165/96 mm Hg and 24-hour mean blood pressure was 150/88 mm Hg. Changes in clinic (primary end point) and ambulatory systolic blood pressures at week 12 were significantly greater in both azilsartan medoxomil/chlorthalidone arms than in the olmesartan/hydrochlorothiazide arm (PϽ0.001). Changes in clinic systolic blood pressure (meanϮSE) were Ϫ42.5Ϯ0. 1 Therefore, there is a need for more effective antihypertensive regimens that include simple single-pill fixed-dose combination (FDC) products.Azilsartan medoxomil is a newly approved, effective, long-acting angiotensin II receptor blocker (ARB). It is a prodrug that is quickly hydrolyzed to the active moiety azilsartan, a potent and selective ARB with estimated bioavailability of 60% and elimination half-life of 12 hours.2 At its maximal dose, azilsartan medoxomil has superior efficacy compared with both olmesartan and valsartan at their maximum, approved doses, without increasing adverse events. [3][4][5] Chlorthalidone is a potent, long-acting thiazide-like diuretic that has a strong evidence base supporting cardiovascular benefit from randomized, controlled clinical trials. [6][7][8][9][10][11][12] It is also more effective in lowering BP than the more commonly used thiazide diuretic, hydrochlorothiazide.13 Therefore, combinations of azilsartan medoxomil and chlorthalidone are being developed as an effective 2-drug FDC.The present multicenter study is a large, forced-titration, active-comparator study of an ARB-chlorthalidone combination. We compared the antihypertensive efficacy, safety, and tolerability of azilsartan medoxomil plus chlorthalidone with

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“…Finally, Izzo et al investigated the effects of intensive BP-lowering strategy of the combination therapy based on olmesartan/HCTZ in patients with stage 2 systolic hypertension (n = 170) [46]. In this open-label, 16-week trial, eligible hypertensive patients received olmesartan 20 mg/day for 3 weeks.…”

Section: Combination Therapy With Olmesartan and Thiazide Diureticsmentioning

confidence: 98%

Fixed-combination therapy to improve blood pressure control: experience with olmesartan-based therapy

Volpe

2011

Expert Review of Cardiovascular Therapy

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Effective treatment of high blood pressure represents a key strategy for reducing the burden of hypertension-related cardiovascular diseases. In spite of these well-established concepts, hypertension remains poorly controlled worldwide. In addition, treated hypertensive patients often remain at higher risk compared with the normotensive population, even when a satisfactory blood pressure control is achieved, owing to a high or very high added cardiovascular risk profile. An emerging strategy to improve blood pressure control in hypertensive patients is a more extensive use of combination therapy than monotherapy in the daily clinical practice. Within the possible antihypertensive drug combinations currently available for the clinical management of hypertension, those based on the association of drugs inhibiting the renin-angiotensin system and thiazide diuretics or calcium channel-blockers have demonstrated to be effective and safe in lowering both systolic and diastolic blood pressure levels with a good tolerability profile. This article provides an overview of fixed-combination strategies, with a particular focus on the fixed-combination strategies based on olmesartan medoxomil.

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Efficacy and Safety of Treating Stage 2 Systolic Hypertension With Olmesartan and Olmesartan/HCTZ: Results of an Open‐Label Titration Study

Cited by 39 publications

References 39 publications

Effect of an Olmesartan Medoxomil-Based Treatment Algorithm on Systolic Blood Pressure in Patients with Stage 1 or 2 Hypertension

Effect of an Olmesartan Medoxomil-Based Treatment Algorithm on Systolic Blood Pressure in Patients with Stage 1 or 2 Hypertension

Azilsartan Medoxomil Plus Chlorthalidone Reduces Blood Pressure More Effectively Than Olmesartan Plus Hydrochlorothiazide in Stage 2 Systolic Hypertension

Fixed-combination therapy to improve blood pressure control: experience with olmesartan-based therapy

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