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Efficacy of aliskiren/hydrochlorothiazide single-pill combinations in aliskiren non-responders

Georg Nickenig1, Vladimir Simanenkov, Giuseppe Lembo

  • 1Universitätsklinikum Bonn, Bonn, Germany. georg.nickenig@ukb.uni-bonn.de

Blood Pressure. Supplement
|February 11, 2009
PubMed

Insights

Adding hydrochlorothiazide to aliskiren significantly improved blood pressure control in hypertensive patients unresponsive to aliskiren monotherapy. The single-pill combination demonstrated greater efficacy and similar tolerability compared to aliskiren alone.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Clinical Hypertension Research

Background:

  • Hypertension remains a global health challenge requiring effective therapeutic strategies.
  • Aliskiren, a direct renin inhibitor, is used for hypertension but may require add-on therapy for inadequate responses.
  • Assessing combination therapies is crucial for optimizing blood pressure management.

Purpose of the Study:

  • To evaluate the efficacy, safety, and tolerability of a single-pill combination of aliskiren and hydrochlorothiazide (HCT).
  • To determine if this combination improves blood pressure (BP) control in patients with inadequate response to aliskiren monotherapy.

Main Methods:

  • A randomized, double-blind study involving 880 hypertensive patients with inadequate BP response to aliskiren 300 mg.
  • Patients received once-daily aliskiren/HCT (300/25 mg or 300/12.5 mg) or aliskiren 300 mg monotherapy.
  • BP changes from baseline were analyzed at the 8-week endpoint in the intent-to-treat population.

Main Results:

  • Aliskiren/HCT 300/25 mg and 300/12.5 mg yielded significantly greater reductions in systolic/diastolic BP (15.9/11.0 mmHg and 13.5/10.5 mmHg) compared to aliskiren alone (8.0/7.4 mmHg).
  • BP control rates (<140/90 mmHg) were significantly higher with aliskiren/HCT combinations (60.2% and 57.9%) versus aliskiren monotherapy (40.9%).
  • The tolerability of the aliskiren/HCT single-pill combinations was comparable to aliskiren monotherapy.

Conclusions:

  • Single-pill combinations of aliskiren/HCT offer clinically significant additional BP reductions.
  • These combinations improve BP control rates in patients non-responsive to aliskiren monotherapy.
  • Aliskiren/HCT combination therapy is an effective option for difficult-to-control hypertension.
Abstract

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