Safety, tolerability, and efficacy of a fixed-dose combination of olmesartan 40 mg and hydrochlorothiazide 12.5/25 mg in daily practice

Bramlage, Peter; Zemmrich, Claudia; Ketelhut, Reinhard G.; Wolf, Wolf-Peter; Fronk, Eva-Maria; Schmieder, Roland E.

doi:10.2147/vhrm.s49118

Cited by 7 publications

(8 citation statements)

References 30 publications

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“…Combination therapy may lower pill burden and improve adherence and clinical outcomes in some cases, without an increase in costs [170]; acceptability to therapy may be high, but discontinuation of medications, nevertheless, still occurs [171]. Combination therapy may also help synergistic enhancement of drug effects and reduction in adverse effects, with positive influence on safety and tolerability [104,172,173]. Triple fixed-dose combination therapy with an ARB, a CCB, and a thiazide favorably impact BP control [174].…”

Section: Referencesmentioning

confidence: 99%

Tolerability of Antihypertensive Medications in Older Adults

Dharmarajan

2015

Drugs Aging

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Several guidelines for hypertension have recently undergone revisions to incorporate an approach providing choices of medications based on age, race, and specific situations where hypertension may co-exist with disorders such as diabetes, coronary artery disease, heart failure and chronic kidney disease. Initial recommendations include diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers; beta blockers are favored in some guidelines and are a choice in specific settings. Within the classes of drugs, several antihypertensive agents provide options. This review discusses antihypertensive drugs by class, including adverse effects and tolerability, with preferences in older adults and specific settings. Adverse drug events from antihypertensive medications are discussed by class and where applicable for specific agents. Data from select studies pertinent to tolerability and adverse effects are presented in tables for several classes of drugs. The rationale for nonadherence to medication is reviewed, including the roles played by tolerability and adverse drug effects. Antihypertensive therapy in typical settings in older adults is discussed; they include hypertension in association with impaired cognition, depression, diabetes, sexual dysfunction, and falls. The key to successful therapy and tolerability is to promote a healthy lifestyle in conjunction with medications as the approach, thereby also lowering the adverse drug effects. The eventual choice of the specific drug(s) is based on risks, benefits, and patient preferences, and is best tailored for each older adult.

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Section: Referencesmentioning

confidence: 99%

Tolerability of Antihypertensive Medications in Older Adults

Dharmarajan

2015

Drugs Aging

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“…Diuretic : Although the combination of diuretics and ACEI/ARB has been merged as one of the most common regimes in treating hypertension, the role of diuretics on treating arterial stiffness has not been well explored. 58 77 A 4-week study demonstrated that hydrochlorthiazide failed to decrease PWV and AIx in spite of a reduction in brachial BP, which imply no favourable effect of diuretics on arterial stiffness beyond BP reduction. 76 …”

Section: The De-stiffening Therapy and Stroke Preventionmentioning

confidence: 99%

Arterial stiffness and stroke: de-stiffening strategy, a therapeutic target for stroke

et al. 2017

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Stroke is the second leading cause of mortality and morbidity worldwide. Early intervention is of great importance in reducing disease burden. Since the conventional risk factors cannot fully account for the pathogenesis of stroke, it is extremely important to detect useful biomarkers of the vascular disorder for appropriate intervention. Arterial stiffness, a newly recognised reliable feature of arterial structure and function, is demonstrated to be associated with stroke onset and serve as an independent predictor of stroke incidence and poststroke functional outcomes. In this review article, different measurements of arterial stiffness, especially pressure wave velocity, were discussed. We explained the association between arterial stiffness and stroke occurrence by discussing the secondary haemodynamic changes. We reviewed clinical data that support the prediction role of arterial stiffness on stroke. Despite the lack of long-term randomised double-blind controlled therapeutic trials, it is high potential to reduce stroke prevalence through a significant reduction of arterial stiffness (which is called de-stiffening therapy). Pharmacological interventions or lifestyle modification that can influence blood pressure, arterial function or structure in either the short or long term are promising de-stiffening therapies. Here, we summarised different de-stiffening strategies including antihypertension drugs, antihyperlipidaemic agents, chemicals that target arterial remodelling and exercise training. Large and well-designed clinical trials on de-stiffening strategy are needed to testify the prevention effect for stroke. Novel techniques such as modern microscopic imaging and reliable animal models would facilitate the mechanistic analyses in pathophysiology, pharmacology and therapeutics.

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“…Studies of OLM, both as monotherapy and, to a greater extent, as a component of combination therapies, have consistently demonstrated that it has a better tolerability profile than placebo and that the risk of drug-related adverse events is at least comparable to that with other ARBs and lower than with any other antihypertensive drug class, including diuretics [ 46 – 49 ]. Of note, the incidence of drug-related adverse events was largely independent of dose titration and was, in fact, lower when the drug was used in fixed-dose combination therapies with HCTZ, AML or both [ 46 – 49 ].…”

Section: Specific Forms Of Hypertensionmentioning

confidence: 99%

Personalised Single-Pill Combination Therapy in Hypertensive Patients: An Update of a Practical Treatment Platform

Volpe

Sierra

Kreutz

et al. 2017

High Blood Press Cardiovasc Prev

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Despite the improvements in the management of hypertension during the last three decades, it continues to be one of the leading causes of cardiovascular morbidity and mortality worldwide. Effective and sustained reductions in blood pressure (BP) reduce the incidence of myocardial infarction, stroke, congestive heart failure and cardiovascular death. However, the proportion of patients who achieve the recommended BP goal (< 140/90 mmHg) is persistently low, worldwide. Poor adherence to therapy, complex therapeutic regimens, clinical inertia, drug-related adverse events and multiple risk factors or comorbidities contribute to the disparity between the potential and actual BP control rate. Previously we published a practical therapeutic platform for the treatment of hypertension based on clinical evidence, guidelines, best practice and clinical experience. This platform provides a personalised treatment approach and can be used to improve BP control and simplify treatment. It uses long-acting, effective and well-tolerated angiotensin receptor blocker (ARB) olmesartan, in combination with a calcium channel blocker amlodipine, and/or a thiazide diuretic hydrochlorothiazide. These drugs were selected based on the availability in most European Countries of single-pill, fixed formulations in a wide range of doses for both dual- and triple-drug combinations. The platform approach could be applied to other ARBs or angiotensin-converting enzyme inhibitors available in single-pill, fixed-dose combinations. Here, we present an update, which takes into account the results of the recently published studies and extends the applicability of the platform to common conditions that are often neglected or poorly considered in clinical practice guidelines.Electronic supplementary materialThe online version of this article (doi:10.1007/s40292-017-0239-7) contains supplementary material, which is available to authorized users.

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Safety, tolerability, and efficacy of a fixed-dose combination of olmesartan 40 mg and hydrochlorothiazide 12.5/25 mg in daily practice

Cited by 7 publications

References 30 publications

Tolerability of Antihypertensive Medications in Older Adults

Tolerability of Antihypertensive Medications in Older Adults

Arterial stiffness and stroke: de-stiffening strategy, a therapeutic target for stroke

Personalised Single-Pill Combination Therapy in Hypertensive Patients: An Update of a Practical Treatment Platform

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