TY - JOUR
T1 - Combination angiotensin-receptor blocker (ARB)/calcium channel blocker with HCTZ vs the maximal recommended dose of an ARB with HCTZ in patients with stage 2 hypertension
T2 - The exforge as compared to losartan treatment in stage 2 systolic hypertension (EXALT) study
AU - Wright, Richard F.
AU - Duprez, Daniel
AU - Purkayastha, Das
AU - Samuel, Rita
AU - Ferdinand, Keith C.
N1 - Funding Information:
Received February 18, 1999. Accepted October 25, 1999. From The Department of Atherosclerosis, Metabolism and Clinical Nutrition, and Research Institute, National Cardiovascular Center, Osaka, Japan. This study was supported in part by Special Coordination Funds for promoting Science and Technology (Encouragement System of
PY - 2011/8
Y1 - 2011/8
N2 - This study compared the efficacy and safety of combination angiotensin-receptor blocker (ARB)/calcium-channel blocker (CCB) with hydrochlorothiazide (valsartan/amlodipine/HCTZ 160/5/25mg) vs maximal available combination doses of an ARB with HCTZ (losartan/HCTZ 100/25mg) in the management of stage2 hypertension. After 1 to 2weeks of antihypertensive drug washout, patients with a mean sitting systolic blood pressure (MSSBP) of ≥160 mm Hg and <200mmHg were randomized to valsartan/amlodipine 160/5mg (n=241) or losartan 100mg (n=247). At week3, HCTZ 25mg was added to both treatments. The primary end point, reduction in MSSBP from baseline to week6, was significantly greater in the valsartan/amlodipine group than in the losartan group (least-squares [LS] mean change, -31.8 mm Hg vs -26.4mmHg; P<.001). Additional reductions occurred after titrating to 320/10/25 mg at week6 in the valsartan/amlodipine group and switching from losartan/HCTZ to valsartan/amlodipine/HCTZ (week6, 160/5/25mg; week9, 320/10/25mg) in the losartan group. Achievement of blood pressure <140/90 mmHg also favored the valsartan/amlodipine group. Dizziness was the only adverse event reported in >5% of patients (5.4% valsartan/amlodipine group, 3.6% losartan group). Moderate doses of an ARB/CCB combination with HCTZ reduced blood pressure more effectively than the maximal dose of an ARB with HCTZ.
AB - This study compared the efficacy and safety of combination angiotensin-receptor blocker (ARB)/calcium-channel blocker (CCB) with hydrochlorothiazide (valsartan/amlodipine/HCTZ 160/5/25mg) vs maximal available combination doses of an ARB with HCTZ (losartan/HCTZ 100/25mg) in the management of stage2 hypertension. After 1 to 2weeks of antihypertensive drug washout, patients with a mean sitting systolic blood pressure (MSSBP) of ≥160 mm Hg and <200mmHg were randomized to valsartan/amlodipine 160/5mg (n=241) or losartan 100mg (n=247). At week3, HCTZ 25mg was added to both treatments. The primary end point, reduction in MSSBP from baseline to week6, was significantly greater in the valsartan/amlodipine group than in the losartan group (least-squares [LS] mean change, -31.8 mm Hg vs -26.4mmHg; P<.001). Additional reductions occurred after titrating to 320/10/25 mg at week6 in the valsartan/amlodipine group and switching from losartan/HCTZ to valsartan/amlodipine/HCTZ (week6, 160/5/25mg; week9, 320/10/25mg) in the losartan group. Achievement of blood pressure <140/90 mmHg also favored the valsartan/amlodipine group. Dizziness was the only adverse event reported in >5% of patients (5.4% valsartan/amlodipine group, 3.6% losartan group). Moderate doses of an ARB/CCB combination with HCTZ reduced blood pressure more effectively than the maximal dose of an ARB with HCTZ.
UR - http://www.scopus.com/inward/record.url?scp=79960958944&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79960958944&partnerID=8YFLogxK
U2 - 10.1111/j.1751-7176.2011.00492.x
DO - 10.1111/j.1751-7176.2011.00492.x
M3 - Article
C2 - 21806769
AN - SCOPUS:79960958944
SN - 1524-6175
VL - 13
SP - 588
EP - 597
JO - Journal of Clinical Hypertension
JF - Journal of Clinical Hypertension
IS - 8
ER -