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Combination therapy with olmesartan medoxomil and hydrochlorothiazide: Secondary analysis of the proportion of patients achieving recommended blood pressure goals from a randomized, double-blind, factorial study
American Journal of Cardiovascular Drugs, 08/12/09

Chrysant SG et al. – Most pts with uncomplicated stage 2 hypertension can achieve recommended blood pressure (BP) goals when treated with combination olmesartan medoxomil and hydrochlorothiazide (HCTZ).

Methods

Secondary analysis to evaluate the proportion of pts achieving combined SBP/DBP targets recommended in current hypertension treatment guidelines and individual SBP and DBP targets
Subjects: 502 pts with DBP ≥100 and ≤115 mmHg across 12 treatment arms
Randomization to 8 wks of treatment with placebo, HCTZ (12.5 or 25 mg/day), olmesartan medoxomil (10, 20, or 40 mg/day), or olmesartan medoxomil/HCTZ (10/12.5, 10/25, 20/12.5, 20/25, 40/12.5, or 40/25 mg/day)
Mean baseline SBP ranged from 151.9-156.6 mmHg
Mean baseline DBP ranged from 102.6-104.4 mmHg
Chi-square test to compare proportion of pts achieving each BP goal in each of 11 active treatment regimens vs placebo group

Results

Proportion of pts achieving SBP <140 or <130 mmHg, DBP <90, <85, or <80 mmHg and combined SBP/DBP <140/90, <130/85, <130/80, or <120/80 mmHg typically increased with escalating dosages of olmesartan medoxomil and HCTZ alone or in combination
Proportion always highest with combination treatment
With progressively more stringent BP goals, proportion of patients achieving BP goal decreased in each treatment group
Trend toward greater reductions remained for combination-therapy pts
All combined SBP/DBP goals achieved by statistically significant proportion of patients in olmesartan medoxomil/HCTZ 20/25, 40/12.5, and 40/25 treatment groups

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