TY - JOUR
T1 - Treating systolic hypertension in the very elderly with valsartan-hydrochlorothiazide vs either monotherapy
T2 - ValVET primary results
AU - Izzo, Joseph L.
AU - Weintraub, Howard S.
AU - Duprez, Daniel A.
AU - Purkayastha, Das
AU - Zappe, Dion
AU - Samuel, Rita
AU - Cushman, William C.
PY - 2011/10
Y1 - 2011/10
N2 - This 16-week trial investigated the efficacy and safety of single-pill valsartan/hydrochlorothiazide (HCTZ) vs the individual components in patients 70years and older with systolic hypertension. Patients were randomized to valsartan/HCTZ 160/12.5mg (n=128), HCTZ 12.5mg (n=128), or valsartan 160mg (n=128) for 4weeks. Patients whose blood pressure (BP) was ≥140/90mmHg at weeks 4, 8, or 12 were up-titrated to a maximum of valsartan/HCTZ 320/25mg. Week 4 systolic BP reduction (primary efficacy outcome) was greater with valsartan/HCTZ than valsartan (-17.3mmHg vs -8.6mmHg, P<.0001) but only marginally greater than HCTZ (-13.6mmHg, P = .096). Median time to BP control was shorter with valsartan/HCTZ (4weeks) vs HCTZ (8weeks, P<.05) or valsartan (12weeks, P<.0001). Thiazide monotherapy was more effective than angiotensin receptor blocker monotherapy (by about 5mmHg), but greater antihypertensive efficacy was achieved by initiating treatment with combination valsartan/HCTZ in the elderly.
AB - This 16-week trial investigated the efficacy and safety of single-pill valsartan/hydrochlorothiazide (HCTZ) vs the individual components in patients 70years and older with systolic hypertension. Patients were randomized to valsartan/HCTZ 160/12.5mg (n=128), HCTZ 12.5mg (n=128), or valsartan 160mg (n=128) for 4weeks. Patients whose blood pressure (BP) was ≥140/90mmHg at weeks 4, 8, or 12 were up-titrated to a maximum of valsartan/HCTZ 320/25mg. Week 4 systolic BP reduction (primary efficacy outcome) was greater with valsartan/HCTZ than valsartan (-17.3mmHg vs -8.6mmHg, P<.0001) but only marginally greater than HCTZ (-13.6mmHg, P = .096). Median time to BP control was shorter with valsartan/HCTZ (4weeks) vs HCTZ (8weeks, P<.05) or valsartan (12weeks, P<.0001). Thiazide monotherapy was more effective than angiotensin receptor blocker monotherapy (by about 5mmHg), but greater antihypertensive efficacy was achieved by initiating treatment with combination valsartan/HCTZ in the elderly.
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U2 - 10.1111/j.1751-7176.2011.00498.x
DO - 10.1111/j.1751-7176.2011.00498.x
M3 - Article
C2 - 21974759
AN - SCOPUS:80053564778
SN - 1524-6175
VL - 13
SP - 722
EP - 730
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
IS - 10
ER -