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This prespecified subgroup analysis of a phase  III  study examined the effect of adding hydrochlorothiazide ( HCTZ ) to olmesartan ( OLM )/amlodipine ( AML ) in patients with moderate to severe hypertension stratified by age, sex, body mass index, and hypertension severity. A total of 2690 patients, aged 18 years and older, with seated  blood pressure  (Se BP ) ≥160/100 mm Hg received placebo or  OLM / AML  20/5 mg, 40/5 mg, or 40/10 mg during a 2‐week, double‐blind, run‐in period, after which they were allocated to one of eight treatment groups with the same  OLM / AML  dose or with  HCTZ  12.5 mg or 25 mg added for 8 weeks. By week 10, greater reductions in Se BP  were observed in each  OLM / AML / HCTZ  group ( P <.05, respectively) compared with the corresponding dual dose. Adding  HCTZ  increased blood pressure–lowering efficacy in all subgroups, with a higher proportion of  blood pressure  goal achievement vs dual therapy.  OLM / AML / HCTZ  reduced Se BP  to a greater extent than  OLM / AML  in patients with moderate to severe hypertensive; this was unaffected by baseline hypertension severity, age, sex, and obesity.

the journal of clinical hypertension

Efficacy and Tolerability of Triple‐Combination Therapy With Olmesartan, Amlodipine, and Hydrochlorothiazide: A Subgroup Analysis of Patients Stratified by Hypertension Severity, Age, Sex, and Obesity