Abstract | BACKGROUND: OBJECTIVE/METHODS: We compared FDCs of AZL-M/CTD 20/12.5 mg once daily titrated to 40/25 mg if needed or AZL-M/CTD 40/12.5 mg once daily titrated to 80/25 mg if needed with an olmesartan medoxomil (OLM)- hydrochlorothiazide ( HCTZ) 20/12.5 mg FDC once daily titrated to 40/25 mg if needed in a randomized, double-blind, 8-week study of 1085 participants with clinic SBP 160-190 mmHg and DBP 119 mmHg or less. Titration to higher doses occurred at week 4 if BP was at least 140/90 mmHg (≥130/80 mmHg if diabetes or chronic kidney disease). The primary endpoint was change from baseline in clinic SBP; 24-h ambulatory BP monitoring was also measured. RESULTS: Greater reductions in clinic SBP from a baseline of 165 mmHg were observed (P < 0.001) in both AZL-M/CTD arms (-37.6 and -38.2 mmHg) versus OLM/ HCTZ (-31.5 mmHg), despite greater dose titration in the OLM/ HCTZ group. At 8 weeks, both AZL-M/CTD FDCs reduced 24-h SBP more than OLM/ HCTZ (-26.4 and -27.9 versus -20.7 mmHg; both P < 0.001), and higher proportions in both AZL-M/CTD groups achieved target BP compared with the OLM/ HCTZ group (69.4 and 68.9 versus 54.7%, both P < 0.001). Adverse events leading to drug discontinuation occurred in 6.2, 9.5, and 3.1% with the AZL-M/CTD lower and higher doses, and OLM/ HCTZ, respectively. CONCLUSION: This large, titration-to-target BP study demonstrated AZL-M/CTD FDCs to have superior antihypertensive efficacy compared with the maximum approved dose of OLM/ HCTZ.
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Authors | William C Cushman, George L Bakris, William B White, Michael A Weber, Domenic Sica, Andrew Roberts, Eric Lloyd, Stuart Kupfer |
Journal | Journal of hypertension
(J Hypertens)
Vol. 36
Issue 4
Pg. 947-956
(04 2018)
ISSN: 1473-5598 [Electronic] Netherlands |
PMID | 29334491
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
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Chemical References |
- Antihypertensive Agents
- Benzimidazoles
- Diuretics
- Drug Combinations
- Imidazoles
- Oxadiazoles
- Tetrazoles
- Hydrochlorothiazide
- olmesartan
- azilsartan medoxomil
- Chlorthalidone
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Topics |
- Aged
- Antihypertensive Agents
(administration & dosage)
- Benzimidazoles
(administration & dosage)
- Blood Pressure
(drug effects)
- Chlorthalidone
(administration & dosage)
- Diuretics
(administration & dosage)
- Double-Blind Method
- Drug Combinations
- Female
- Humans
- Hydrochlorothiazide
(administration & dosage)
- Hypertension
(drug therapy, physiopathology)
- Imidazoles
(administration & dosage)
- Male
- Middle Aged
- Oxadiazoles
(administration & dosage)
- Tetrazoles
(administration & dosage)
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