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Irbesartan/Hydrochlorothiazide : in moderate to severe hypertension

Jamie D Croxtall1, Gillian M Keating

  • 1Wolters Kluwer Health | Adis, Auckland, New Zealand. demail@adis.co.nz

Drugs
|June 27, 2008
PubMed

Insights

Fixed-dose irbesartan/hydrochlorothiazide combination therapy effectively lowers blood pressure in patients with moderate to severe hypertension. This combination demonstrated superior efficacy compared to monotherapy, with a comparable safety profile.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Hypertension remains a significant global health concern requiring effective therapeutic strategies.
  • Current guidelines recommend combination therapy for patients not achieving blood pressure goals with monotherapy.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of fixed-dose irbesartan/hydrochlorothiazide (HCTZ) combination therapy.
  • To compare irbesartan/HCTZ with irbesartan or HCTZ monotherapy in patients with moderate and severe hypertension.

Main Methods:

  • Two randomized, double-blind, multicentre trials were conducted.
  • Trial 1: 538 patients with moderate hypertension, assessing efficacy at 8 and 12 weeks.
  • Trial 2: 697 patients with severe hypertension, assessing efficacy at 5 and 7 weeks.

Main Results:

  • Irbesartan/HCTZ significantly reduced seated systolic blood pressure (SeSBP) more than monotherapy in moderate hypertension.
  • A greater proportion of patients achieved controlled blood pressure (< 140/90 mmHg) with irbesartan/HCTZ in both moderate and severe hypertension trials.
  • Combination therapy showed similar tolerability to monotherapy, with mostly mild to moderate adverse events.

Conclusions:

  • Fixed-dose irbesartan/HCTZ is an effective initial therapy for patients likely to require multiple agents for blood pressure control.
  • The combination therapy offers a statistically significant improvement in achieving blood pressure goals compared to monotherapy.
  • Irbesartan/HCTZ provides a favorable benefit-risk profile for managing hypertension.

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