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Zappe D et al. – At study end, 78.8% of patients on valsartan ± HCTZ were controlled (BP < 140/90 mmHg) and still on study medication versus 67.8% on amlodipine ± HCTZ. Amlodipine–treated patients had a higher incidence of peripheral edema (22.4% vs 2.2%) and associated discontinuations (7.3% vs <1%). Initiating therapy earlier with valsartan/HCTZ, rather than titrating monotherapy to its maximum dose before adding a second agent, was superior to amlodipine monotherapy or amlodipine ± HCTZ for achieving BP control, and avoided excessive treatment adjustments and maintained tolerability.

   

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