Source: DGNews  |  Posted 4 years ago

By Jill Stein

CHICAGO, IL -- May 23, 2007 -- Treatment with a fixed-dose combination of irbesartan and hydrochlorothiazide (HCTZ) provides equal blood pressure control in all patients with moderate or severe hypertension regardless of the presence of cardiovascular risk factors, researchers reported here at the 22[^]nd[] Annual Meeting of the American Society of Hypertension (ASH).

The findings showed that presence of advanced age, obesity, and type 2 diabetes did not affect treatment outcomes, the researchers said in a presentation on May 21[^]st[].

Matthew Weir, MD, head, division of nephrology, University of Maryland School of Medicine, Baltimore, Maryland, United States, and colleagues studied the antihypertensive efficacy and tolerability of irbesartan/hydrochlorothiazide (HCTZ) fixed-dose combination in patients with moderate or severe hypertension with or without high cardiovascular risk.

In their large, open-label study, the researchers used data from 2 randomised, double-blind, active-controlled studies that enrolled 762 adult patients with hypertension who were treated with once-daily irbesartan/HCTZ 150/12.5 mg force titrated to 300/25 mg.

"Guidelines for the treatment of hypertension indicate that patients at high risk for cardiovascular disease may benefit more from aggressive treatment of their condition," Dr. Weir explained. "Certain patient subgroups at high risk for cardiovascular disease -- including patients with advanced age, obesity, and/or type 2 diabetes -- have special needs with respect to the efficacy and tolerability of antihypertensive medication."

In the study, irbesartan/HCTZ combination therapy was effective in getting patients with uncontrolled hypertension, including the elderly and patients with type 2 diabetes and metabolic syndrome, rapidly to their blood pressure goal.

More information is needed on the efficacy and safety of irbesartan/HCTZ combination therapy in hypertensive patients at high cardiovascular risk, and specifically in the elderly, obese, and those with diabetes, he added.

Patients with available efficacy data were pooled and classified into subgroups by age or <65 years (n=110 vs 618), the presence or absence of obesity (body mass index 30 kg/m[^]2[]) (n=340 vs 385), and the presence or absence of type 2 diabetes (n=87 vs 641).

Seated systolic blood pressure lowering effect of the combination treatment was similar among patients with high and low cardiovascular risk (-30.4 vs -28.4 mm Hg).

The seated diastolic blood pressure lowering effect of treatment was greater in the high cardiovascular risk group than in the low cardiovascular risk group (-22.1 vs -15.6 mm Hg).

The decrease in baseline seated systolic blood pressure and seated diastolic blood pressure with irbesartan/HCTZ 300/25 mg therapy ranged from 30.3 to 29.8 mm Hg and 20.7 to 19.3 mmHg, respectively, and was similar in subjects who were less than 65 years of age or 65 years of age and older.

The decrease in baseline seated systolic blood pressure and seated diastolic blood pressure ranged from 26.7 to 30.3 mm Hg and 17.0 to 20.9 mm Hg, respectively, in patients with and without diabetes.

The decrease in baseline seated systolic blood pressure and seated diastolic blood pressure ranged from 29.2 to 30.6 mm Hg and 19.9 to 20.9 mm Hg, respectively, and was similar in persons with and without obesity.

The frequency of adverse effects was similar among the patient subgroups. Dizziness, hypotension, and syncope occurred infrequently in all subgroups.

"The study shows that irbesartan/HCTZ combination therapy provided equal blood pressure control in all groups of patients, simplifying hypertension treatment regimens," Dr. Weir said.

The study was supported by Bristol-Myers Squibb and Sanofi-Aventis.

[[]Presentation title: Irbesartan/Hydrochlorothiazide Fixed-Dose Combination Is Effective and Well Tolerated in Moderate to Severe Hypertensive Patients with and without Advanced Age, Obesity, and/or Type 2 Diabetes. Abstract P-447[]]