Efficacy and tolerability of combination therapy with valsartan plus hydrochlorothiazide compared with amlodipine monotherapy in hypertensive patients with other cardiovascular risk factors: The VAST study

Ruilope, Luís M.; Malacco, Ettore; Khder, Yasser; Kandra, Albert; Bönner, Gerd; Heintz, Daniela

doi:10.1016/j.clinthera.2005.05.006

Cited by 82 publications

(58 citation statements)

References 21 publications

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“…Although we do not know precisely why valsartan did not reduce serum CRP in this study, two possible explanations are that the dose of valsartan was relatively low and the characteristics of the participants were different from those in previous reports. 17,18 In addition, the ARB group showed a significant reduction of PTX3 in blood in this study. The relative increase in PTX3 at 24 h after coronary stenting was the most powerful predictor of late lumen loss.…”

Section: Discussionmentioning

confidence: 71%

“…8 Valsartan also reduced plasma levels of CRP in hypertensive patients with left ventricular hypertrophy 17 and in hypertensive patients with other cardiovascular risk factors. 18 In this study, olmesartan but not valsartan significantly decreased the serum level of CRP. Although there are many CRPlowering agents such as statins, b-blocker, calcium channel blockers and thiazolidine, 16 there were no significant differences in the percentage of medications between the olmesartan and valsartan groups.…”

Section: Discussionmentioning

confidence: 86%

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Safety and efficacy of antihypertensive therapy with add-on angiotensin II type 1 receptor blocker after successful coronary stent implantation

et al. 2009

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This study was performed to evaluate the safety and efficacy of additional antihypertensive therapy with angiotensin II type 1 receptor blocker (ARB; olmesartan or valsartan) after successful stent implantation in patients with coronary artery disease (CAD). Fifty patients with CAD after successful stent implantation were included in this study. They were divided into an ARB group, which initially received olmesartan (n¼20, 14±8 mg day À1 ) or valsartan (n¼20, 60±23 mg day À1 ) immediately after stent implantation, and a non-ARB group (n¼10) according to their blood pressure (BP). Follow-up coronary angiography, measurement of BP and blood sampling were performed before (at baseline) and 6-8 months after stent implantation (at follow-up). There were no significant differences in the baseline characteristics between the groups, except for BP. Although there were no changes in % diameter restenosis between the groups, the BP level in the ARB group at follow-up showed a significant reduction (125 ± 12/69 ± 9 mm Hg) and reached the target BP. There were no critical adverse effects in the ARB group throughout the study period. In addition, serum high-sensitive C-reactive protein (hs-CRP) and pentraxin 3 were significantly decreased in the ARB group but not in the non-ARB group. Although olmesartan and valsartan induced similar BP-lowering effects, olmesartan but not valsartan induced a significant decrease in hs-CRP, but did not increase serum uric acid. In conclusion, antihypertensive therapy with add-on low-dose ARB after stent implantation was safe and achieved the target BP. In particular, olmesartan had an anti-inflammatory effect.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 86%

Safety and efficacy of antihypertensive therapy with add-on angiotensin II type 1 receptor blocker after successful coronary stent implantation

et al. 2009

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“…Supporting this, according to Everett et al, the incidence of HTN was more commonly seen in patients below 65 years (85.9-87.7%) in comparison to patients above 65 years (12.3-14.0%) [17]. Lacourciere et al [18] and Ruilope et al levels [19] had also been consistent with the current study showing the mean age to be 60-61 years; however; in a study carried out by Yasmeen et al, 31.7% patients belonged to 51-60 years age group followed by 28.9% in 41-50 years age group with the least (3.5%) being 71-80 years age group [20]. The rationale for an increase in blood pressure with age could probably be due to structural changes in the arteries and especially with large artery stiffness [21].…”

Section: Discussionmentioning

confidence: 51%

Comparison of Efficacy and Adverse Drug Reactions of Monotherapy Versus Combination Therapy of Antihypertensives Among Diabetic Hypertensive Patients in a Tertiary Care Hospital

Bairy

2017

Asian J Pharm Clin Res

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Objective: To compare the efficacy and adverse drug reactions of monotherapy and combination therapy of antihypertensive drugs in diabetic hypertensive patients. Methods:A prospective observational study of 18 months duration was conducted in the Department of Medicine of a tertiary care hospital in South India. A total of 200 patients were included in the study. Using a standard proforma, the details of patients such as demographic data and antihypertensive medications were collected and analyzed for efficacy and safety.Results: Of 200 patients studied, 50% received monotherapy whereas the remaining 50% received combination therapy. There was male preponderance (54%) in the study population, with the mean age being 60.07±11.32 years. In monotherapy group, most commonly prescribed drug was amlodipine (38%), whereas in combination group, angiotensin receptor blocker (ARB) or calcium channel blocker (CCB) + beta blocker (18%) was commonly prescribed among 2-drug group and ARB+ thiazide+ CCB (25.6%) among 3-drug group. Monotherapy and combination therapy were analyzed to be equally efficacious in reducing systolic blood pressure and diastolic blood pressure. Based on the adverse effect profile, monotherapy comparatively produced more adverse effects than combination group. Amlodipine-induced pedal edema (56.7%) was the most common adverse effect observed, and it was predominantly managed by changing it to be a better tolerable CCB, namely cilnidipine. Conclusion:The combination therapy may be a better treatment option in selected patient population.

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“…2-6 K Studies have shown that the combination of an angiotensin receptor blocker, such as valsartan (Val), with the diuretic hydrochlorothiazide (HCTZ), has enhanced efficacy compared with component monotherapies and is well tolerated in hypertensive patients; [17][18][19][20] and, the single-pill combination has been recently approved in the United States as initial therapy.…”

Section: Conflict Of Interestmentioning

confidence: 99%

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

et al. 2010

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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.

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Efficacy and tolerability of combination therapy with valsartan plus hydrochlorothiazide compared with amlodipine monotherapy in hypertensive patients with other cardiovascular risk factors: The VAST study

Cited by 82 publications

References 21 publications

Safety and efficacy of antihypertensive therapy with add-on angiotensin II type 1 receptor blocker after successful coronary stent implantation

Safety and efficacy of antihypertensive therapy with add-on angiotensin II type 1 receptor blocker after successful coronary stent implantation

Comparison of Efficacy and Adverse Drug Reactions of Monotherapy Versus Combination Therapy of Antihypertensives Among Diabetic Hypertensive Patients in a Tertiary Care Hospital

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

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