Pulse Pressure Responses in Patients Treated with Valsartan and Hydrochlorothiazide Combination Therapy

Carretta, Renzo; Trenkwalder, Peter; Martínez, Felipe A.; Tykarski, Andrzej; Teitelbaum, I.; Fagan, Timothy C.; Oddou, Pascale; Mallion, Jean-Michel

doi:10.1177/147323000303100503

Cited by 6 publications

(2 citation statements)

References 21 publications

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“…Valsartan does not lead to disturbances in orthostatic adaptation after passive tilting of subjects, [18] and there is no consistent influence on the hemodynamic consequences of sympathetic stimulation of the cardiovascular system by exercise; observations in line with effects expected from a specific AT 1 -receptor blockade without interference with other regulatory systems [19]. There have been no effects on pulse rates in clinical trials [20]. In subjects with normal sodium intake, valsartan has no effects on water or electrolyte excretion, nor on creatinine clearance [18].…”

Section: Pharmacodynamicsmentioning

confidence: 53%

Valsartan in The Treatment of Hypertension

et al. 2005

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Valsartan is a widely used, efficacious and very well-tolerated antihypertensive agent. By specifically blocking the action of angiotensin II on the angiotensin Type 1 receptor, valsartan reduces unwanted effects of angiotensin II, such as aldosterone, vasopressin and endothelin secretion, vasoconstriction, diuresis, endothelial cell hyperplasia, mitogenesis, induction of growth factors and production of collagen. Valsartan has a simple pharmacokinetic profile and requires no metabolism to become active. The dose-related efficacy of valsartan has been clearly demonstrated and the tolerability profile is similar to placebo. Clinical trials in elderly patients show good efficacy and high responder rates with the same doses as in younger patients. Valsartan is available as 80-, 160-and 320-mg tablets, and also in the same doses in combination with hydrochlorothiazide, 12.5 or 25 mg. Availability varies between countries. Beyond the reduction of blood pressure, valsartan is indicated for use in several countries in patients with heart failure and in patients post myocardial infarction, based on the results of the large-scale Valsartan Heart Failure Trial and VALsartan In Acute myocardial iNfarcTion trials. Valsartan has also been shown, in the Valsartan Antihypertensive Long-term Evaluation trial, to reduce the risk of developing new-onset diabetes in hypertensive patients at high risk of cardiac events.

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Section: Pharmacodynamicsmentioning

confidence: 53%

Valsartan in The Treatment of Hypertension

et al. 2005

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“…On the other hand, the reduction in PP was more apparent with lisinopril + hydrochlorothiazide and valsartan + hydrochlorothiazide than with lisinopril and valsartan alone. And similarly, in Caretta et al's study, valsartan + hydrochlorothiazide was more powerful in reducing PP than valsartan alone [27] Moreover, with increasing dose of hydrochlorothiazide, from 25 to 50 mg, without changing the valsartan dose, the reduction in PP was more apparent. So, although indapamide showed a nonsignificant reduction in PP, it is not possible to make conclusion that all diuretics have the same effect.…”

Section: Discussionmentioning

confidence: 85%

Effect of Seven Different Modalities of Antihypertensive Therapy on Pulse Pressure in Patients with Newly Diagnosed Stage I Hypertension

Alıcı

Aliyev

Bellur

et al. 2009

Cardiovascular Therapeutics

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In this study, we investigated the effect of different antihypertensive agents on pulse pressure (PP). The study was designed in a prospective manner and patients were sequentially allocated to one of the seven different therapy groups, according to the order of enrollment (every first patient to group I, every second patient to group II, and etc). Patients in group I received 10 mg of lisinopril, in group II 10/6.25 mg of lisinopril/hydrochlorothiazide, in group III 80 mg of valsartan, in group IV 80/6.25 mg of valsartan/hydrochlorothiazide, in group V 5 mg of amlodipine, in group VI 1.25 mg of indapamide, and finally those in group VII received 50 mg of atenolol. The reduction in PP was more significant in patients receiving lisinopril, lisinopril hydrochlorothiazide, valsartan, and valsartan hydrochlorothiazide, when compared with patients receiving indapamide, atenolol, and amlodipine (P < 0.05 for each group). Factors such as age, gender, and body mass index were not found to significantly influence the effectiveness of antihypertensive agents on PP. The reduction in PP was more apparent with lisinopril, lisinopril hydrochlorothiazide, valsartan, and valsartan hydrochlorothiazide in diabetic patients, when compared with those without diabetes (P < 0.001, P < 0.05). And also patients on therapy with 3‐hydroxy‐3‐methyl‐glutaryl‐CoA (HMG‐CoA) reductase inhibitors had a greater reduction in PP with lisinopril, lisinopril hydrochlorothiazide, valsartan, and valsartan hydrochlorothiazide (P < 0.001, P < 0.05).

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Hypertension therapy: Mixing, matching, and meeting targets

Volpe

2004

Adv Therapy

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The inappropriate control of hypertension is a public health problem worldwide. It is notable that although there are several causes for this situation, lack of effective pharmacotherapy is not among them. It has long been known that combinations of antihypertensive drugs are highly effective in most patients; the problem is implementing treatment recommendation guidelines into clinical practice with the most effective and best tolerated therapies. The latest guidelines on therapies for hypertension from the World Health Organization/International Society of Hypertension, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (US), and the European Societies of Hypertension and Cardiology consistently emphasize this need of combination treatments in a large part of the hypertensive patient population. This review focuses on the combination of one of the oldest drugs, thiazide diuretics, with one of the youngest, angiotensin-receptor blockers, and analyzes the available literature regarding potential applications in specific populations. This represents one of the most widely used, rational and effective combination therapies, combining excellent control of blood pressure with unequalled tolerability. In addition, angiotensin-receptor blocker/diuretic combinations may have cardiovascular benefits beyond those from blood pressure lowering itself.

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Pulse Pressure Responses in Patients Treated with Valsartan and Hydrochlorothiazide Combination Therapy

Cited by 6 publications

References 21 publications

Valsartan in The Treatment of Hypertension

Valsartan in The Treatment of Hypertension

Effect of Seven Different Modalities of Antihypertensive Therapy on Pulse Pressure in Patients with Newly Diagnosed Stage I Hypertension

Hypertension therapy: Mixing, matching, and meeting targets

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