期刊
JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION
卷 5, 期 4, 页码 249-258出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jash.2011.02.007
关键词
Racial differences; combination therapy
资金
- Novartis Pharmaceuticals Corporation
- National Institutes of Health (NIH), National Center for Research Resources (NCRR) [UL1 RR025008, U54 RR026137, 2R25RR017694-06A1]
- Forest Laboratories
- Gilead
- Takeda
- Abbott
- Bayer
- Medtronic
- Daiichi Sankyo
- NicOx
- NIH
- Boehringer-Ingelheim
- sanofi-aventis
- Department of Veterans Affairs
Combination therapy may reduce racial/ethnic differences in response to antihypertensives. In this post-hoc analysis, we evaluated treatment response by race/ethnicity among hypertensive adults enrolled in a 12-week, double-blind study in which patients previously uncontrolled (mean sitting systolic blood pressure [MSSBP] >= 150 and <200 mm Hg) on angiotensin receptor blocker (ARB) monotherapy (other than valsartan) for 28 days or more (n = 728) were randomized to amlodipine/valsartan 10/320 mg (intensive) or 5/160 mg (moderate). Treatment-naive patients (in previous 28 days) or those who failed on a non-ARB first underwent a 28-day run-in period with olmesartan 20 mg or 40 mg, respectively. Hydrochlorothiazide (HCTZ) 12.5 mg was added to both arms at week 4; optional up-titration to 25 mg at week 8 (if MSSBP >140 mm Hg). Intensive treatment provided greater BP lowering versus moderate treatment throughout the study, regardless of race/ethnicity (474 white, 198 African American, 165 Hispanic individuals). Least-square mean reductions from baseline to week 4 in MSSBP (primary outcome) ranged from 20.4 to 23.5 mm Hg (intensive) versus 17.5 to 19.0 mm Hg (moderate), across racial/ethnic subgroups. Both regimens were well tolerated. Amlodipine/valsartan/HCTZ combination therapy was efficacious across racial/ethnic subgroups. Maximal efficacy was obtained with intensive treatment. J Am Soc Hypertens 2011;5(4):249-258. (C) 2011 Published by Elsevier Inc on behalf of American Society of Hypertension.
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