Open AccessCombination Angiotensin Receptor Blocker/Hydrochlorothiazide as Initial Therapy in the Treatment of Patients With Severe Hypertension
Author(s) -
Salerno Christina M.,
Demopoulos Laura,
Mukherjee Robin,
Gradman Alan H.
Publication year - 2004
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1524-6175.2004.03808.x
Subject(s) - hydrochlorothiazide , losartan , medicine , tolerability , thiazide , angiotensin receptor , blood pressure , diuretic , urology , combination therapy , regimen , pharmacology , angiotensin ii , adverse effect , endocrinology
Patients with severe hypertension are at high risk for cardiovascular events. The authors hypothesized that initial treatment with a combination angiotensin receptor blocker/diuretic agent would be safe and more effective than initial treatment with a single agent for these patients. In this 6‐week, double‐blind trial, 585 patients were randomized to losartan/hydrochlorothiazide or losartan as monotherapy and titrated as needed at 2‐week intervals to reach goal blood pressure (<90 mm Hg). Almost twice as many patients achieved goal at the primary end point of 4 weeks on 50 mg losartan/12.5 mg hydrochlorothiazide vs. the losartan regimen (50–100 mg; p=0.002). Additionally, almost three times as many patients achieved goal blood pressures at 6 weeks (p<0.001). Adverse experiences on losartan/hydrochlorothiazide (43%) were significantly less than with the angiotensin receptor blocker alone (52.6%). This study confirmed the efficacy and tolerability of initial use of a fixed combination of losartan/hydrochlorothiazide vs. losartan without a thiazide.