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Candesartan plus hydrochlorothiazide fixed combination vs previous monotherapy plus diuretic in poorly controlled

Giuseppe Mancia1, Stefano Omboni,

  • 1Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università degli Studi di Milano-Bicocca, Ospedale San Gerardo, Monza, Italy. giuseppe.mancia@unimib.it

Blood Pressure. Supplement
|January 6, 2005
PubMed

Insights

The fixed combination of candesartan cilexetil (CC) plus hydrochlorothiazide (HCTZ) effectively controlled hypertension, showing a higher normalization rate than previous monotherapy plus HCTZ. This combination offers a safe and effective alternative for managing blood pressure.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Hypertension is a major risk factor for cardiovascular diseases.
  • Effective blood pressure control is crucial for reducing morbidity and mortality.
  • Optimizing antihypertensive drug combinations is essential for patient management.

Purpose of the Study:

  • To compare the efficacy and tolerability of a fixed-dose combination of candesartan cilexetil (CC) plus hydrochlorothiazide (HCTZ) against previous monotherapy (PM) plus HCTZ in hypertensive patients.
  • To evaluate blood pressure reduction and treatment normalization rates in patients receiving CC + HCTZ versus PM + HCTZ.

Main Methods:

  • A PROBE multicenter trial randomized 409 outpatients with uncontrolled hypertension to receive either CC 16 mg + HCTZ 12.5 mg or PM + HCTZ 12.5 mg for 8 weeks.
  • Hydrochlorothiazide dosage was increased in non-responders after 4 weeks.
  • Blood pressure was measured using an automatic oscillometric device.

Main Results:

  • Both CC + HCTZ and PM + HCTZ significantly reduced diastolic and systolic blood pressure.
  • The CC + HCTZ group achieved a higher rate of normalized blood pressure (DBP <90 and/or SBP <140 mmHg) after 8 weeks (82.0% vs 72.6%).
  • The rate of HCTZ dose doubling was lower in the CC + HCTZ group (18.1% vs 31.2%).
  • Adverse event rates were low and comparable between groups.

Conclusions:

  • The fixed combination of candesartan cilexetil plus hydrochlorothiazide is an effective and safe antihypertensive treatment.
  • This combination demonstrates superior efficacy in achieving blood pressure normalization compared to previous monotherapy plus HCTZ.
  • CC + HCTZ offers a valuable alternative for patients whose blood pressure is not adequately controlled by monotherapy or other combinations.
Abstract

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