Office and Ambulatory Blood Pressure–Lowering Effects of Combination Valsartan/Hydrochlorothiazide vs Hydrochlorothiazide-Based Therapy in Obese, Hypertensive Patients
Article first published online: 14 JUL 2011
© 2011 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 13, Issue 10, pages 731–738, October 2011
How to Cite
Raij, L., Egan, B. M., Zappe, D. H., Purkayastha, D., Samuel, R. and Sowers, J. R. (2011), Office and Ambulatory Blood Pressure–Lowering Effects of Combination Valsartan/Hydrochlorothiazide vs Hydrochlorothiazide-Based Therapy in Obese, Hypertensive Patients. The Journal of Clinical Hypertension, 13: 731–738. doi: 10.1111/j.1751-7176.2011.00499.x
- Issue published online: 4 OCT 2011
- Article first published online: 14 JUL 2011
- Manuscript received: February 1, 2011; Revised: May 11, 2011; Accepted: May 14, 2011
J Clin Hypertens (Greenwich). 2011;13:731–738. ©2011 Wiley Periodicals, Inc.
The authors evaluated the blood pressure (BP)–lowering effects of combination valsartan/hydrochlorothiazide (HCTZ) vs amlodipine/HCTZ in a 16-week, double-blind, randomized, forced-titration study and ambulatory BP monitoring (ABPM) substudy involving centrally obese hypertensive patients 40 years and older. Patients were started on valsartan/HCTZ 160/12.5 mg or HCTZ 12.5 mg monotherapy, force-titrated at week 4 to valsartan/HCTZ 320/25 mg and HCTZ 25 mg, respectively. The HCTZ group initiated amlodipine 5 mg at week 8 and 10 mg at week 12. A subset of patients had 24-hour ABPM at baseline and weeks 8 and 16. At week 16 in the intent-to-treat population (n=401), valsartan/HCTZ and amlodipine/HCTZ lowered office systolic BP (−30.6 vs −28.3 mm Hg; P=.14). In the ABPM subgroup (n=111), valsartan/HCTZ was more effective than amlodipine/HCTZ in reducing 24-hour systolic BP (−20.6 vs −14.5 mm Hg; P=.011). In obese hypertensive patients, valsartan/HCTZ reduced office BP similar to amlodipine/HCTZ but lowered 24-hour systolic BP more. J Clin Hypertens (Greenwich). ****;**:**–**.