Trough-to-Peak Ratio, Smoothness Index, and Circadian Blood Pressure Profile After Treatment With Once-Daily Fixed Combination of Losartan 100 and Hydrochlorothiazide 25 in Essential Hypertension

Coca, António; Sobrino, Javier; Soler, J.; Felip, A.; Pelegrí, Antoni; Minguez, A.; Vila, Joaquim; Sierra, Alejandro de la; Plana, Jaume Campistol

doi:10.1097/00005344-200206000-00007

Cited by 18 publications

(14 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…36,55–58 Valsartan plus hydrochlorothiazide reported a similar trough-to-peak ratio (61%/57%) as that reported with valsartan alone in a previously described study (66%) 38,58. Therefore, the duration of action was not affected by the addition of another agent, although BP was lower with the combination treatment.…”

Section: Effect Of Increasing the Number Of Daily Antihypertensive Dosupporting

confidence: 75%

See 1 more Smart Citation

Benefits of once-daily therapies in the treatment of hypertension

Flack¹,

Nasser²

2011

VHRM

View full text Add to dashboard Cite

In patients with hypertension, 24-hour blood pressure control is the major therapeutic goal. The number of daily doses is one characteristic of an antihypertensive agent that may affect the adequacy of 24-hour control. One measure of therapeutic coverage is the 24-hour trough-to-peak ratio, which determines the suitability of an agent for once-daily administration. The closer an agent is to a 100% trough-to-peak ratio, the more uniform the 24-hour coverage and therefore blood pressure control. High trough-to-peak ratio, long-acting antihypertensive medications lower blood pressure more gradually, which reduces the likelihood of adverse events attributable to abrupt drug action that occurs with shorter-acting agents. In hypertension, the natural diurnal variation of blood pressure may be altered, including elevated nighttime pressures. An optimal once-daily hypertension therapy would not only lower blood pressure but also normalize any blunted circadian variations in blood pressure. The benefits of once-daily agents with sustained therapeutic coverage may also be explained, in part, by increased patient adherence to simpler regimens as well as lower loss of blood pressure control during virtually inevitable intermittent noncompliance. Studies have demonstrated that once-daily antihypertensive agents have the highest adherence compared with twice-daily or multiple daily doses, including greater adherence to the prescribed timing of doses.

show abstract

Section: Effect Of Increasing the Number Of Daily Antihypertensive Dosupporting

confidence: 75%

“… Note: Data from Coca et al,36 Coca et al,55 Kuschnir et al,56 Mancia et al,57 and Palatini et al58 Abbreviations: DBP, diastolic blood pressure; GITS, gastrointestinal therapeutic system; HCTZ, hydrochlorothiazide; SBP, systolic blood pressure.…”

Section: Figurementioning

confidence: 99%

Benefits of once-daily therapies in the treatment of hypertension

Flack¹,

Nasser²

2011

VHRM

View full text Add to dashboard Cite

show abstract

“…22 In a study of untreated patients with moderate-to-severe essential hypertension or patients with uncontrolled hypertension despite treatment with monotherapy or low-dose combination, the response rate to losartan 100 mg/HCTZ 25 mg therapy was 87.8% (BP lowering 45 mm Hg of either 24 h SBP or 24 h DBP average values) after 8 weeks. 23 Current and prior clinical experience have shown that treatment with the losartan/HCTZ combination treatment can achieve clinically significant reductions of BP in Asian patients and that the magnitude of the reductions are consistent with those in non-Asian patients. Lower BPs are associated with reduced risk of cardiovascular events; 24 however, there are no end point studies carried out with losartan exclusively in Asian patients.…”

Section: Discussionmentioning

confidence: 88%

Effectiveness of open-label losartan/hydrochlorothiazide combination therapy in Asian patients with hypertension not controlled with ACE inhibitor or ARB monotherapy

et al. 2009

View full text Add to dashboard Cite

Antihypertensive efficacy and safety of losartan/hydrochlorothiazide (HCTZ) combinations have not been adequately studied in Asians. In this open-label, 12-week study in seven Asian areas, patients on monotherapy with angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) but not at blood pressure (BP) goal (sitting diastolic BP (SiDBP) o90 mm Hg in non-diabetics and o80 mm Hg in diabetics) were switched to losartan 50 mg/HCTZ 12.5 mg. At 4 and 8 weeks, the therapy for patients not at goal BP was titrated to losartan 100 mg/HCTZ 12.5 mg and to losartan 100 mg/HCTZ 25 mg, respectively. Data analysis included 430 patients with mean (s.d.) age 53.0 (10.1) years and 51.9% of the female gender. After 8 weeks (primary end point; titration up to losartan 100 mg/HCTZ 12.5 mg), 73.5% (95% confidence interval (CI): 69.0-77.6) of patients reached BP goal; 63.4 and 78.1% of patients reached BP goal at 4 weeks (titration up to losartan 50 mg/HCTZ 12.5 mg) and at 12 weeks (titration up to losartan 100 mg/HCTZ 25 mg). The mean changes from baseline (95% CI) in sitting systolic BP and SiDBP at 8 weeks were À16.7 (À18.0 to À15.4) mm Hg and À12.1 (À12.9 to À11.4) mm Hg, respectively. Clinical and laboratory adverse experiences (AEs) were reported in 27.5 and 21.0% of patients, respectively. Nine patients were discontinued because of drug-related clinical AEs. Switching Asian patients currently not at BP goal with ARB or ACEI monotherapy to a losartan/HCTZ combination achieved BP goal in the majority of patients. Losartan/HCTZ combinations were generally well tolerated.

show abstract

“…Die Kombination von Losartan und HCTZ wurde in zahlreichen Studien eingehend untersucht [9,15,21,33,34,37,41]. Es handelte sich hierbei um Patienten mit allen Schweregraden der Hypertonie, die unter der Monotherapie mit den einzelnen Komponenten nicht eingestellt werden konnten oder primär mit der Kombination behandelt wurden.…”

Section: Antihypertensive Wirksamkeit Und Verträglichkeitunclassified

“…Zusätzlich zur Behandlung mit Losartan ± HCTZ erhielten 54,1% der Patienten noch ein oder mehrere weitere Antihypertensiva. Der systolische/diastolische Blutdruck nahm von einem Ausgangswert von 158,1/90,3 mmHg nach 1-jähriger Behandlung auf 137,3/80,6 mmHg ab (8)(9)7 mmHg). Die Proportion der Patienten mit keiner/leichter/star ker kognitiver Beeinträchtigung betrug zu Beginn 30,0%/30,3%/39,7%, und zum Studienende 34,8%/28,1%/37,1%.…”

unclassified