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Optimizing Blood Pressure Control: A Randomized Comparative Trial of Losartan/Chlorthalidone vs.
Isabel E Rucker-Joerg1, Ernesto G Cardona-Muñoz2, Francisco G Padilla-Padilla3
1Clinical Research Institute, Blvrd. Manuel Avila Camacho #1994, San Lucas Tepetlacalco, Tlalnepantla, Estado de Mexico, Mexico.
Insights
Losartan/chlorthalidone combination therapy effectively reduced blood pressure in hypertensive patients. This combination showed greater efficacy in achieving diastolic blood pressure targets compared to losartan/hydrochlorothiazide, with similar safety profiles.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Hypertension is a major risk factor for cardiovascular diseases, a leading cause of global mortality.
- Low blood pressure control rates are often linked to monotherapy.
- Combination therapies are recommended by clinical guidelines for improved hypertension management.
Purpose of the Study:
- To compare the efficacy of losartan/chlorthalidone (L/C) versus losartan/hydrochlorothiazide (L/H) in reducing blood pressure.
- To evaluate the achievement of target blood pressure levels in hypertensive patients receiving combination therapy.
Main Methods:
- A randomized, double-blind, prospective, multicenter clinical trial.
- Patients were assigned to L/C or L/H, with dose escalation if target blood pressure was not met.
- Blood pressure was monitored at 30 and 60 days.
Main Results:
- Both L/C and L/H significantly reduced systolic and diastolic blood pressure.
- The L/C group showed a greater reduction in diastolic blood pressure and a higher likelihood of achieving blood pressure goals.
- Adverse events were comparable and mild across both treatment groups.
Conclusions:
- Losartan/chlorthalidone and losartan/hydrochlorothiazide are effective antihypertensive combinations.
- Losartan/chlorthalidone demonstrated superior efficacy in reducing diastolic blood pressure and achieving treatment targets.
- Both combination therapies exhibited favorable and similar safety profiles.
Introduction:
Cardiovascular diseases are a leading cause of global mortality, with hypertension as a major risk factor. Low control rates are often attributed to monotherapy, while evidence and clinical guidelines support the effectiveness of combination therapies. This study aimed to evaluate blood pressure changes and the achievement of target levels in patients treated with losartan/chlorthalidone (L/C) compared to losartan/hydrochlorothiazide (L/H).
Methods:
A randomized, double-blind, prospective, multicenter clinical trial was conducted. Patients were assigned to one of two treatment groups, starting with a lower dose (50/12.5 mg of losartan/chlorthalidone or losartan/hydrochlorothiazide). Blood pressure was evaluated at 30 days, and patients not meeting therapeutic goals were escalated to a higher dose (100/50 mg of losartan/chlorthalidone or losartan/hydrochlorothiazide) and followed until the study end (60 days).
Results:
The study recruited 163 patients (83 for losartan/chlorthalidone [L/C] group and 80 for the losartan/hydrochlorothiazide [L/H] group), with a mean age of 53.1 years. Both treatment groups demonstrated significant reductions in systolic and diastolic blood pressure, with L/C achieving an average reduction in systolic blood pressure (SBP) of - 24.6 mmHg and - 13.3 mmHg for diastolic blood pressure (DBP), while L/H had reductions of - 25.3-mmHg and - 11.5 mmHg, respectively. The L/C group exhibited a higher likelihood of achieving blood pressure goals compared to the L/H. Adverse events were comparable between groups and were mostly mild.
Conclusions:
The study showed that both combinations are effective for hypertension, with losartan/chlorthalidone demonstrating greater efficacy in reducing diastolic blood pressure and achieving target levels. Both treatments exhibited similar and favorable safety profiles.
Clinical Trials Registration:
NCT04927299. Registered August 6, 2021- https://clinicaltrials.gov/study/NCT04927299.
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