Open AccessThe Risks and Benefits of Initial Irbesartan/Hydrochlorothiazide Combination Therapy in Patients With Severe Hypertension
Author(s) -
Lapuerta Pablo,
Franklin Stanley
Publication year - 2009
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.1751-7176.2009.00109.x
Subject(s) - irbesartan , medicine , hydrochlorothiazide , thiazide , combination therapy , blood pressure , adverse effect , cardiology , diastole , urology
The impact of delays in blood pressure (BP) reduction is particularly relevant for patients with severe hypertension who are at risk for hypertensive emergencies. Combination therapies may hold promise as initial treatment for these patients. The safety and efficacy of initial irbesartan/hydrochlorothiazide (angiotensin receptor blocker/thiazide) treatment was compared with that of irbesartan as monotherapy in a multicenter, double‐blind, parallel‐group study in patients with severe hypertension. After 5 weeks, 47% of patients receiving combination therapy achieved a target diastolic BP <90 mm Hg compared with 33% with monotherapy ( P =.0005). Similarly, systolic BP/diastolic BP <140/90 mm Hg targets were reached by more subjects treated with combination therapy than subjects receiving monotherapy (34.6% vs 19.2%, P <.0001). Initial use of combination therapy instead of monotherapy is estimated to prevent between 250 and 4500 cardiovascular events in every 100,000 severely hypertensive patients over 5 years, without significantly increasing serious adverse event rates.