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Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients

Hiroki Uchiwa1, Hisashi Kai2, Yoshiko Iwamoto1

  • 1a Department of Internal Medicine, Division of Cardio-Vascular Medicine , Kurume University School of Medicine , Kurume , Japan.

Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|October 31, 2017
PubMed

Insights

The losartan/hydrochlorothiazide combination effectively controlled morning hypertension in both very-elderly and younger patients. This combination therapy proved superior to high-dose losartan alone for reducing morning systolic blood pressure in older adults.

Area of Science:

  • Cardiology
  • Geriatrics
  • Pharmacology

Background:

  • Morning hypertension is a significant risk factor for cerebrovascular and cardiovascular events.
  • Its prevalence increases with age, yet established treatments for very-elderly patients are lacking.

Purpose of the Study:

  • To compare the safety and efficacy of a losartan/hydrochlorothiazide (HCTZ) combination versus high-dose losartan for managing morning hypertension in very-elderly (≥75 years) and younger (<75 years) patients.

Main Methods:

  • A subanalysis of the Morning Hypertension and Angiotensin Receptor Blocker/Hydrochlorothiazide Combination Therapy study.
  • Patients received either 50-mg losartan/12.5-mg HCTZ combination therapy or 100-mg losartan high-dose therapy for 3 months.
  • Adherence rates and adverse effects were monitored.

Main Results:

  • Combination therapy significantly reduced morning systolic blood pressure (SBP) by 20.2 mmHg in very-elderly and 18.1 mmHg in younger patients, compared to 7.1 and 9.1 mmHg with high-dose therapy, respectively.
  • The morning BP target (<135/85 mmHg) was achieved by 40.6% of very-elderly and 55.1% of younger patients on combination therapy.
  • No significant changes in renal function or serum potassium were observed in very-elderly patients with either therapy.

Conclusions:

  • The losartan/HCTZ combination is a safe and effective treatment for morning hypertension in both very-elderly and younger patient groups.
  • Combination therapy demonstrated superior efficacy in lowering morning SBP compared to high-dose losartan monotherapy, particularly in very-elderly individuals.

Keywords:
Ang II receptor blockersantihypertensive therapyclinical trialcombination therapydiureticshome blood pressure measurement

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