24-Hour Ambulatory Blood Pressure Response to Combination Valsartan/Hydrochlorothiazide and Amlodipine/Hydrochlorothiazide in Stage 2 Hypertension by Ethnicity: The EVALUATE Study


Jackson T. Wright, Jr, MD, PhD, Professor of Medicine, Program Director, William T. Dahms, MD, Clinical Research Unit and the Clinical Hypertension Program, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106-6053
E-mail: jxw20@case.edu


J Clin Hypertens (Greenwich).

Several studies reported racial/ethnic differences in blood pressure (BP) response to antihypertensive monotherapy. In a 10-week study of stage 2 hypertension, 320/25 mg valsartan/hydrochlorothiazide (HCTZ) reduced ambulatory BP (ABP) significantly more effectively than 10/25 mg amlodipine/HCTZ. Results (post hoc analysis) are described in Caucasians (n=256), African Americans (n=79), and Hispanics (n=86). Compared with clinic-measured BP (no significant treatment-group differences in ethnic subgroups), least-squares mean reductions from baseline to week 10 in mean ambulatory systolic BP (MASBP) and mean ambulatory diastolic BP (MADBP) favored valsartan/HCTZ over amlodipine/HCTZ in Caucasians (−21.9/−12.7 mm Hg vs −17.6/−9.5 mm Hg; P=.0004/P<.0001). No treatment-group differences in MASBP/MADBP were observed in African Americans (−17.3/−10.6 vs −17.9/−9.5; P=.76/P=.40) or Hispanics (−17.9/−9.7 vs −14.2/−7.2; P=.20/P=.17). Based on ABP monitoring, valsartan/HCTZ is more effective than amlodipine/HCTZ in lowering ABP in Caucasians. In African Americans and Hispanics, both regimens are similarly effective. J Clin Hypertens (Greenwich). 2010;12:833–840.