The velocity of antihypertensive effect of losartan/hydrochlorothiazide and angiotensin II receptor blocker
Journal of Hypertension, 06/21/2012
Metoki H et al. – Changing from a medium dose of angiotensin II receptor blocker (ARB) monotherapy to combination therapy was more effective in the reduction of home SBP and achieved goal blood pressure (BP) more rapidly than increasing the ARB dose. Home BP measurement is a useful tool for characterizing the antihypertensive effects of drugs.Methods
- Essential hypertensive patients treated with a medium dose of ARB, in whom a target home SBP (135mmHg) was not achieved, were randomized into two groups: a combination group (n=110) and a maximal–dose ARB group (n=111).
- The combination therapy provided additional reduction of 5.2mmHg [95% confidence interval (CI) 1.8 to 8.5mmHg, P=0.003] in home SBP over the maximal–dose ARB therapy in 8 weeks after randomization.
- A greater reduction in the home SBP values was seen in the combination group than in the maximal–dose ARB group from the second day after randomization on the basis of a linear mixed model.
- The maximum antihypertensive effect and stabilization time for home SBP were 10.9±5.0mmHg and 7.3±29.7 days, respectively, in the combination group, whereas the corresponding values in the maximal–dose ARB group were 7.9±2.6 mmHg and 122.3±42.7 days, respectively, on the basis of a nonlinear mixed model.