Evaluation of the Dose Response With Valsartan and Valsartan/Hydrochlorothiazide in Patients With Essential Hypertension

Authors

  • Matthew R. Weir MD,

    1. From the Department of Medicine, Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD;1 and Novartis Pharmaceuticals Corporation, East Hanover, NJ2
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  • 1 Nora Crikelair BS,

    1. From the Department of Medicine, Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD;1 and Novartis Pharmaceuticals Corporation, East Hanover, NJ2
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  • 2 Drew Levy PhD,

    1. From the Department of Medicine, Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD;1 and Novartis Pharmaceuticals Corporation, East Hanover, NJ2
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  • 2 Ricardo Rocha MD,

    1. From the Department of Medicine, Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD;1 and Novartis Pharmaceuticals Corporation, East Hanover, NJ2
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  • 2 Venkatram Kuturu MS,

    1. From the Department of Medicine, Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD;1 and Novartis Pharmaceuticals Corporation, East Hanover, NJ2
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  • and 2 Robert Glazer MD 2

    1. From the Department of Medicine, Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD;1 and Novartis Pharmaceuticals Corporation, East Hanover, NJ2
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Matthew R. Weir, MD, Division of Nephrology, University of Maryland School of Medicine, 22 South Greene Street, Room N3W143, Baltimore, MD 21201
E-mail: mweir@medicine.umaryland.edu

Abstract

This patient data meta-analysis included 9 randomized, double-blind, placebo-controlled trials (N=4278) of once-daily valsartan 80, 160, or 320 mg or valsartan/hydrochlorothiazide 80/12.5, 160/12.5, 160/25, 320/12.5, or 320/25 mg given for 4 to 8 weeks. Efficacy variables included: (1) mean change in systolic blood pressure (BP) and diastolic BP; and (2) proportion of patients reaching BP goal (<140/90 mm Hg) at the end of the study. Results showed that incremental systolic and diastolic BP reductions were achieved with increasing doses. Starting doses of valsartan 160 mg provided greater BP reductions and a higher proportion of patients reaching goal than 80 mg; combination therapy was more effective than monotherapy. BP goal rates increased incrementally with higher doses. With valsartan/hydrochlorothiazide 320/25 mg, 74.9% overall, 88.8% of stage 1, and 62.1% of stage 2 patients reached BP goal. The rate of discontinuation due to adverse events was low with both monotherapy and combination treatment. Higher starting doses may enable patients to achieve greater initial BP reductions and reach BP goal more rapidly.

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