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document
Effectiveness of initiating treatment with valsartan/hydrochlorothiazide in patients with stage-1 or stage-2 hypertension . This prospective , 6-week , multicenter , double-blind study examined the benefits of initiating treatment with combination valsartan/hydrochlorothiazide ( HCTZ ) compared with initial valsartan monotherapy for 648 patients with stage-1 or stage-2 hypertension ( age=52.6+/-10 years ; 54 % male ; baseline blood pressure ( BP ) =161/98 mm Hg , 32 % stage 1 ) . Patients were randomized to valsartan 80 mg ( V-low ) , valsartan 160 mg ( V-high ) or valsartan/HCTZ 160/12.5 mg ( V/HCTZ ) , and electively titrated after weeks 2 and 4 to the next dosage level ( maximum dose valsartan/HCTZ 160/25 mg ) if BP remained > 140/90 mm Hg . At end of the study , patients initiated with V/HCTZ required less titration steps compared with the initial valsartan monotherapy groups ( 63 vs 86 % required titration by study end , respectively ) and reached the target BP goal of < 140/90 mm Hg in a shorter period of time ( 2.8 weeks ) ( P < 0.0001 ) vs V-low ( 4.3 weeks ) and V-high ( 3.9 weeks ) . Initial combination therapy was also associated with higher BP control rates and greater reductions in both systolic and diastolic BP from baseline ( 63 % , -27.7+/-13/-15.1+/-8 mm Hg ) compared with V-low ( 46 % , -21.2+/-13/-11.4+/-8 mm Hg , P < 0.0001 ) or V-high ( 51 % , -24.0+/-13/-12.0+/-10 mm Hg , P < 0.01 ) . Overall and drug-related AEs were mild to moderate and were similar between V/HCTZ ( 53.1 and 14.1 % , respectively ) and the two monotherapy groups , V-low ( 50.5 and 13.8 % ) and V-high ( 50.7 and 11.8 % ) . In conclusion , initiating therapy with a combination of valsartan and low-dose HCTZ results in early , improved BP efficacy with similar tolerability as compared with starting treatment with a low or higher dose of valsartan for patients with stage-1 and stage-2 hypertension .
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Intervention_Pharmacological
valsartan/hydrochlorothiazide
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Intervention_Pharmacological
valsartan/hydrochlorothiazide ( HCTZ )
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Intervention_Pharmacological
valsartan 80 mg ( V-low )
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Intervention_Pharmacological
valsartan 160 mg ( V-high )
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Intervention_Pharmacological
valsartan/HCTZ 160/12.5 mg ( V/HCTZ )
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Intervention_Pharmacological
maximum dose valsartan/HCTZ 160/25 mg
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Intervention_Pharmacological
BP remained > 140/90 mm Hg
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Intervention_Pharmacological
V/HCTZ
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Intervention_Pharmacological
V/HCTZ
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Intervention_Pharmacological
valsartan
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Intervention_Pharmacological
HCTZ
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Intervention_Pharmacological
valsartan
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Outcome_Other
less titration steps
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Outcome_Physical
BP goal
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Outcome_Physical
BP control rates
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Outcome_Other
reductions in both systolic and diastolic BP
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Outcome_Adverse-effects
drug-related AEs
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Outcome_Other
early , improved
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Outcome_Physical
BP efficacy
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Outcome_Other
tolerability
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Participant_Condition
patients with stage-1 or stage-2 hypertension .
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Participant_Sample-size
648
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Participant_Age
age=52.6+/-10 years
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Participant_Sex
male