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Randomized Controlled Trial
. 2010 Nov;12(11):833-40.
doi: 10.1111/j.1751-7176.2010.00372.x. Epub 2010 Sep 24.

24-Hour ambulatory blood pressure response to combination valsartan/hydrochlorothiazide and amlodipine/hydrochlorothiazide in stage 2 hypertension by ethnicity: the EVALUATE study

Jackson T Wright Jr  1 , Yves Lacourcière, Rita Samuel, Dion Zappe, Das Purkayastha, Henry R Black
Affiliations
Randomized Controlled Trial

24-Hour ambulatory blood pressure response to combination valsartan/hydrochlorothiazide and amlodipine/hydrochlorothiazide in stage 2 hypertension by ethnicity: the EVALUATE study

Jackson T Wright Jr et al. J Clin Hypertens (Greenwich). 2010 Nov.

Abstract

Several studies reported racial/ethnic differences in blood pressure (BP) response to antihypertensive monotherapy. In a 10-week study of stage 2 hypertension, 320/25 mg valsartan/hydrochlorothiazide (HCTZ) reduced ambulatory BP (ABP) significantly more effectively than 10/25 mg amlodipine/HCTZ. Results (post hoc analysis) are described in Caucasians (n=256), African Americans (n=79), and Hispanics (n=86). Compared with clinic-measured BP (no significant treatment-group differences in ethnic subgroups), least-squares mean reductions from baseline to week 10 in mean ambulatory systolic BP (MASBP) and mean ambulatory diastolic BP (MADBP) favored valsartan/HCTZ over amlodipine/HCTZ in Caucasians (-21.9/-12.7 mm Hg vs -17.6/-9.5 mm Hg; P=.0004/P<.0001). No treatment-group differences in MASBP/MADBP were observed in African Americans (-17.3/-10.6 vs -17.9/-9.5; P=.76/P=.40) or Hispanics (-17.9/-9.7 vs -14.2/-7.2; P=.20/P=.17). Based on ABP monitoring, valsartan/HCTZ is more effective than amlodipine/HCTZ in lowering ABP in Caucasians. In African Americans and Hispanics, both regimens are similarly effective.

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Figures

Figure 1
Figure 1
Change in (A) mean ambulatory systolic blood pressure (MASBP) and (B) mean ambulatory diastolic blood pressure (MADBP) from baseline to week 10 by race/ethnicity. HCTZ indicates hydrochlorothiazide; LS, least squares.
Figure 2
Figure 2
Proportion of patients achieving (A) clinic blood pressure (BP) goal (<140/90 mm Hg) and (B) ambulatory BP goal (<130/80 mm Hg) at week 10 by race/ethnicity. HCTZ indicates hydrochlorothiazide.
See this image and copyright information in PMC

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