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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Volpe, Massimo Miele, Cristina Haag, Uwe |
| Description | Country affiliation: Italy Author Affiliation: Volpe M ( Specialty School of Cardiology, University of Rome 'La Sapienza', Rome, Italy. massimo.volpe@uniroma1.it) |
| Abstract | BACKGROUND: Treatment guidelines recommend combination therapy to control blood pressure (BP) in the majority of hypertensive patients. This long-term open-label study assessed a treatment algorithm based on olmesartan medoxomil (hereafter olmesartan), amlodipine and hydrochlorothiazide (HCTZ). METHODS: Patients with moderate-to-severe hypertension who were inadequately controlled with amlodipine 5 mg/day monotherapy and who subsequently completed 16 weeks of double-blind combination treatment with olmesartan and amlodipine entered a 28-week open-label phase in which all patients initially received olmesartan/amlodipine 40/5 mg/day. After 4, 10 and 19 weeks, patients with inadequately controlled hypertension (seated trough diastolic [DBP] and systolic [SBP] BP >/=90 mmHg and >/=140 mmHg, respectively) had their doses increased in a step-wise manner to: (i) olmesartan/amlodipine 40/10 mg; (ii) olmesartan/amlodipine/HCTZ 40/10/12.5 mg; and (iii) olmesartan/amlodipine/HCTZ 40/10/25 mg. RESULTS: In total, 692 patients entered the open-label phase (691 on olmesartan/amlodipine 40/5 mg). The majority of patients remained on olmesartan/amlodipine 40/5 mg without dose elevation, and, of these, 74.3% achieved goal BP at study completion or early termination. Additional patients achieved goal BP with each successive uptitration of therapy: in patients who finished the study on olmesartan/amlodipine 40/10 mg and olmesartan/amlodipine/HCTZ 40/10/12.5 mg, the respective proportions who reached goal BP were 59.0% and 47.1%. Overall, 66.9% of patients achieved the European guideline recommended goal BP of SBP <140 mmHg and DBP <90 mmHg for patients without diabetes mellitus, and SBP <130 mmHg and DBP <80 mmHg for patients with diabetes. Treatment was generally well tolerated, with no unexpected safety concerns. CONCLUSIONS: A treatment algorithm based on olmesartan/amlodipine (+/- HCTZ) provides a high degree of BP control in patients with moderate-to-severe hypertension. The open-label study design suggests similar results are obtainable in clinical practice. |
| File Format | HTM / HTML |
| ISSN | 11732563 |
| Issue Number | 6 |
| Volume Number | 29 |
| e-ISSN | 11791918 |
| Journal | Clinical Drug Investigation |
| Language | English |
| Publisher | Springer |
| Publisher Date | 2009-01-01 |
| Publisher Place | New Zealand (Aotearoa) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Pharmacology Amlodipine Therapeutic Use Angiotensin Ii Type 1 Receptor Blockers Calcium Channel Blockers Diuretics Hydrochlorothiazide Hypertension Drug Therapy Imidazoles Tetrazoles Adult Aged Aged, 80 And Over Administration & Dosage Adverse Effects Drug Administration Schedule Drug Combinations Drug Therapy, Combination Female Humans Male Middle Aged Olmesartan Medoxomil Practice Guidelines As Topic Clinical Trial Journal Article Research Support, Non-u.s. Gov't |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pharmacology (medical) |
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