Source: Eur Urol  |  Posted 5 years ago

By Ed Susman

NEW YORK, NY -- May 18, 2006 -- Patients with moderate to severe high blood pressure get greater benefit from initial treatment with combination irbesartan/hydrochlorothiazide therapy than with irbesartan monotherapy, researchers reported at the 21[^]st[] annual scientific meeting and exposition of the American Society of Hypertension (ASH).

Joel Neutel, MD, medical director, Orange County Heart Institute and Research Center, Tustin, California, and colleagues randomized patients to receive combination therapy consisting of irbesartan 150 mg and hydrochlorothiazide 12.5 mg, titrated irbesartan 300 mg/hydrochlorothiazide 25 mg. A second group was randomized to irbesartan monotherapy with 150 mg, titrated to 300 mg.

The researchers enlisted 697 patients in the study, assigning 468 to combination therapy and 229 to monotherapy.

After 5 weeks, 37% of patients who received combination therapy had reached a normotensive goal compared with 21% of those on monotherapy. That difference reached statistical significance at the P =.0003 level, he said.

An additional 5% of patients remained with severe hypertension in the combination therapy, compared with 14% of patients on monotherapy. That difference was also statistically significant at the P <.001 level, he said.

"Combination therapy with irbesartan/hydrochlorothiazide therapy exposed fewer persons in the treatment population to severe hypertension," Dr. Neutel said during his poster presentation May 16[^]th[].

"Initial treatment with irbesartan/hydrochlorothiazide was more effective than monotherapy in achieving rapid blood pressure control in severe hypertension," he reported. Dr. Neutel said that the safety profile of the combination therapy was similar to monotherapy with the angiotensin receptor blocker.

A 10 mm Hg greater decrease in systolic blood pressure was observed among subjects on combination therapy compared with those on monotherapy. That difference became significant (P <.05) at week 1 and continued through week 7.

[Presentation title: Irbesartan/HCTZ Combination Therapy as Initial Treatment for Severe Hypertension to Achieve Rapid BP Control. Abstract 106]