Markers of Inflammation Under Combination Treatment With Statin in Hypertensives With Metabolic Syndrome: PP.5.195

Abstract

Objective: Obesity and age are major risk factors for hypertension and activation of the renin-angiotensin-aldosterone system is an important mechanism in obesity-associated hypertension. We previously reported in an 8-week, prospective, multicenter, randomized, double-blind study (N¼380) that a single-pill combination of aliskiren (A) with hydrochlorothiazide (HCTZ) provided significantly greater office blood pressure (BP) reductions than ramipril (R) in obese patients (body mass index [BMI] >¼30 kg/m 2 but <¼45 kg/m 2 ) with stage 2 hypertension (mean sitting systolic BP [msSBP] >¼160 mmHg and <200 mmHg). Here we present the results stratified by patient age.Design and Methods: After a 1-4 week washout period, eligible patients with a mean BMI AE standard deviation (SD)¼35.3 AE 4.4 kg/m 2 received AþHCTZ 150/12.5 mg or R 5 mg for 1 week; force-titrated to AþHCTZ 300/ 25 mg or R 10 mg for an additional 7 weeks. The primary efficacy variable was the change from baseline to week 8 in msSBP.Results: At week 8, both AþHCTZ and R reduced (P < 0.05) msSBP in all age groups. However, significantly greater reductions in msSBP in favor of AþHCTZ were observed in both elderly and non-elderly age groups (least squares [LS] mean change from baseline ranged from -21.1 to -32.4 mmHg) compared with R (LS mean change ranged from -10.2 to -17.4 mm Hg). In the overall study, adverse event rates were similar in both groups (35.8%, AþHCTZ; 37.3%, R), the most common being headache, nasopharyngitis, dizziness, and fatigue.