Abstract
This study compared the efficacy and safety of combination angiotensin-receptor blocker (ARB)/calcium-channel blocker (CCB) with hydrochlorothiazide (valsartan/amlodipine/HCTZ 160/5/25mg) vs maximal available combination doses of an ARB with HCTZ (losartan/HCTZ 100/25mg) in the management of stage2 hypertension. After 1 to 2weeks of antihypertensive drug washout, patients with a mean sitting systolic blood pressure (MSSBP) of ≥160 mm Hg and <200mmHg were randomized to valsartan/amlodipine 160/5mg (n=241) or losartan 100mg (n=247). At week3, HCTZ 25mg was added to both treatments. The primary end point, reduction in MSSBP from baseline to week6, was significantly greater in the valsartan/amlodipine group than in the losartan group (least-squares [LS] mean change, -31.8 mm Hg vs -26.4mmHg; P<.001). Additional reductions occurred after titrating to 320/10/25 mg at week6 in the valsartan/amlodipine group and switching from losartan/HCTZ to valsartan/amlodipine/HCTZ (week6, 160/5/25mg; week9, 320/10/25mg) in the losartan group. Achievement of blood pressure <140/90 mmHg also favored the valsartan/amlodipine group. Dizziness was the only adverse event reported in >5% of patients (5.4% valsartan/amlodipine group, 3.6% losartan group). Moderate doses of an ARB/CCB combination with HCTZ reduced blood pressure more effectively than the maximal dose of an ARB with HCTZ.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 588-597 |
| Number of pages | 10 |
| Journal | Journal of Clinical Hypertension |
| Volume | 13 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2011 |
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Combination angiotensin-receptor blocker (ARB)/calcium channel blocker with HCTZ vs the maximal recommended dose of an ARB with HCTZ in patients with stage 2 hypertension : The exforge as compared to losartan treatment in stage 2 systolic hypertension (EXALT) study. / Wright, Richard F.; Duprez, Daniel; Purkayastha, Das; Samuel, Rita; Ferdinand, Keith C.
In: Journal of Clinical Hypertension, Vol. 13, No. 8, 01.08.2011, p. 588-597.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Combination angiotensin-receptor blocker (ARB)/calcium channel blocker with HCTZ vs the maximal recommended dose of an ARB with HCTZ in patients with stage 2 hypertension
T2 - The exforge as compared to losartan treatment in stage 2 systolic hypertension (EXALT) study
AU - Wright, Richard F.
AU - Duprez, Daniel
AU - Purkayastha, Das
AU - Samuel, Rita
AU - Ferdinand, Keith C.
PY - 2011/8/1
Y1 - 2011/8/1
N2 - This study compared the efficacy and safety of combination angiotensin-receptor blocker (ARB)/calcium-channel blocker (CCB) with hydrochlorothiazide (valsartan/amlodipine/HCTZ 160/5/25mg) vs maximal available combination doses of an ARB with HCTZ (losartan/HCTZ 100/25mg) in the management of stage2 hypertension. After 1 to 2weeks of antihypertensive drug washout, patients with a mean sitting systolic blood pressure (MSSBP) of ≥160 mm Hg and <200mmHg were randomized to valsartan/amlodipine 160/5mg (n=241) or losartan 100mg (n=247). At week3, HCTZ 25mg was added to both treatments. The primary end point, reduction in MSSBP from baseline to week6, was significantly greater in the valsartan/amlodipine group than in the losartan group (least-squares [LS] mean change, -31.8 mm Hg vs -26.4mmHg; P<.001). Additional reductions occurred after titrating to 320/10/25 mg at week6 in the valsartan/amlodipine group and switching from losartan/HCTZ to valsartan/amlodipine/HCTZ (week6, 160/5/25mg; week9, 320/10/25mg) in the losartan group. Achievement of blood pressure <140/90 mmHg also favored the valsartan/amlodipine group. Dizziness was the only adverse event reported in >5% of patients (5.4% valsartan/amlodipine group, 3.6% losartan group). Moderate doses of an ARB/CCB combination with HCTZ reduced blood pressure more effectively than the maximal dose of an ARB with HCTZ.
AB - This study compared the efficacy and safety of combination angiotensin-receptor blocker (ARB)/calcium-channel blocker (CCB) with hydrochlorothiazide (valsartan/amlodipine/HCTZ 160/5/25mg) vs maximal available combination doses of an ARB with HCTZ (losartan/HCTZ 100/25mg) in the management of stage2 hypertension. After 1 to 2weeks of antihypertensive drug washout, patients with a mean sitting systolic blood pressure (MSSBP) of ≥160 mm Hg and <200mmHg were randomized to valsartan/amlodipine 160/5mg (n=241) or losartan 100mg (n=247). At week3, HCTZ 25mg was added to both treatments. The primary end point, reduction in MSSBP from baseline to week6, was significantly greater in the valsartan/amlodipine group than in the losartan group (least-squares [LS] mean change, -31.8 mm Hg vs -26.4mmHg; P<.001). Additional reductions occurred after titrating to 320/10/25 mg at week6 in the valsartan/amlodipine group and switching from losartan/HCTZ to valsartan/amlodipine/HCTZ (week6, 160/5/25mg; week9, 320/10/25mg) in the losartan group. Achievement of blood pressure <140/90 mmHg also favored the valsartan/amlodipine group. Dizziness was the only adverse event reported in >5% of patients (5.4% valsartan/amlodipine group, 3.6% losartan group). Moderate doses of an ARB/CCB combination with HCTZ reduced blood pressure more effectively than the maximal dose of an ARB with HCTZ.
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UR - http://www.scopus.com/inward/citedby.url?scp=79960958944&partnerID=8YFLogxK
U2 - 10.1111/j.1751-7176.2011.00492.x
DO - 10.1111/j.1751-7176.2011.00492.x
M3 - Article
C2 - 21806769
AN - SCOPUS:79960958944
VL - 13
SP - 588
EP - 597
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
SN - 1524-6175
IS - 8
ER -