Effects of high dose olmesartan medoxomil plus hydrochlorothiazide on blood
pressure control in patients with grade 2 and grade 3 hypertension.
Author(s): Rump LC, Girerd X, Sellin L, Stegbauer J.
Affiliation(s): Department of Internal Medicine/Nephrology, Heinrich-Heine-University Dusseldorf,
Dusseldorf, Germany. Christian.rump@med.uni-duesseldorf.de
Publication date & source: 2011, J Hum Hypertens. , 25(9):565-74
High dose (40 mg) olmesartan medoxomil (OM) blocks the angiotensin II receptor,
significantly reducing blood pressure (BP). Adding hydrochlorothiazide (HCTZ) to
OM increases efficacy, but has not been evaluated in patients inadequately
controlled by OM 40 mg. Patients with grade 2 and grade 3 hypertension with
inadequately controlled BP (seated diastolic blood pressure [SeDBP] 90-115 mm Hg
and seated systolic blood pressure [SeSBP] 140-180 mm Hg, plus ambulatory BP
criteria) after 8 weeks of OM 40 mg open-label treatment were randomized to 8
weeks of double-blind treatment with OM/HCTZ 40/25 (n=140), 40/12.5 (n=278),
20/12.5 mg (n=280) or OM 40 mg (n=274). Treatment with OM/HCTZ 40/25 mg and
40/12.5 mg significantly reduced SeDBP (-5.3 and -3.4 mm Hg, respectively), and
SeSBP (-7.4 and -5.2 mm Hg, respectively), vs OM 40 mg monotherapy (P<0.0001 for
each) in patients inadequately controlled on OM 40 mg alone. OM/HCTZ 40/12.5 mg
reduced SeSBP significantly more than OM/HCTZ 20/12.5 mg (-2.6 mm Hg, P=0.0255),
and also produced a further reduction in SeDBP vs the lower dose. All treatments
were well tolerated, with similar low proportions of patients reporting
treatment-emergent adverse events in all treatment groups. In conclusion, adding
HCTZ to OM 40 mg significantly improves BP reductions and target BP rates in
harder-to-treat patients and a clear dose-response was observed for efficacy.
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