Treating Systolic Hypertension in the Very Elderly With Valsartan-Hydrochlorothiazide vs Either Monotherapy: ValVET Primary Results
Article first published online: 14 JUL 2011
© 2011 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 13, Issue 10, pages 722–730, October 2011
How to Cite
Izzo Jr, J. L., Weintraub, H. S., Duprez, D. A., Purkayastha, D., Zappe, D., Samuel, R. and Cushman, W. C. (2011), Treating Systolic Hypertension in the Very Elderly With Valsartan-Hydrochlorothiazide vs Either Monotherapy: ValVET Primary Results. The Journal of Clinical Hypertension, 13: 722–730. doi: 10.1111/j.1751-7176.2011.00498.x
- Issue published online: 4 OCT 2011
- Article first published online: 14 JUL 2011
- Manuscript received: February 4, 2011; Revised: April 27, 2011; Accepted: May 4, 2011
J Clin Hypertens (Greenwich). 2011;13:722–730. ©2011 Wiley Periodicals, Inc.
This 16-week trial investigated the efficacy and safety of single-pill valsartan/hydrochlorothiazide (HCTZ) vs the individual components in patients 70 years and older with systolic hypertension. Patients were randomized to valsartan/HCTZ 160/12.5 mg (n=128), HCTZ 12.5 mg (n=128), or valsartan 160 mg (n=128) for 4 weeks. Patients whose blood pressure (BP) was ≥140/90 mm Hg at weeks 4, 8, or 12 were up-titrated to a maximum of valsartan/HCTZ 320/25 mg. Week 4 systolic BP reduction (primary efficacy outcome) was greater with valsartan/HCTZ than valsartan (−17.3 mm Hg vs −8.6 mm Hg, P <.0001) but only marginally greater than HCTZ (−13.6 mm Hg, P =.096). Median time to BP control was shorter with valsartan/HCTZ (4 weeks) vs HCTZ (8 weeks, P<.05) or valsartan (12 weeks, P<.0001). Thiazide monotherapy was more effective than angiotensin receptor blocker monotherapy (by about 5 mm Hg), but greater antihypertensive efficacy was achieved by initiating treatment with combination valsartan/HCTZ in the elderly.