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. 2012:2012:976828.
doi: 10.1155/2012/976828. Epub 2012 Jul 10.

Effects of Telmisartan with Hydrochlorothiazide versus Valsartan with Hydrochlorothiazide in Patients with Moderate-to-Severe Hypertension

Ravi Marfatia  1 , William B White, Helmut Schumacher
Affiliations

Effects of Telmisartan with Hydrochlorothiazide versus Valsartan with Hydrochlorothiazide in Patients with Moderate-to-Severe Hypertension

Ravi Marfatia et al. Int J Hypertens. 2012.

Abstract

Combination therapy is recommended for patients with blood pressure (BP) significantly above goal by recent consensus guidelines around the globe. The use of angiotensin II receptor blockers (ARBs) alone or in combination with a thiazide diuretic is a preferred treatment strategy due to both efficacy and safety considerations. However, there are few data known about the benefits of ARB-diuretic combination therapy in patients with moderate-to-severe hypertension. We performed a subanalysis from two large clinical trials that compared the antihypertensive effects of telmisartan 80 mg versus valsartan 160 mg, both combined with hydrochlorothiazide (HCTZ) 25 mg in a subpopulation of 725 patients with moderate-to-severe hypertension (systolic BP SBP ≥ 160 mm Hg). Treatment with telmisartan-HCTZ induced significantly greater reductions in BP (-31.1/-18.3 mm Hg) than valsartan-HCTZ (-28.4/-16.3 mm Hg; SBP P = 0.0265, diastolic BP P = 0.0041). More patients receiving the telmisartan combination achieved a BP goal < 140/90 mm Hg than those receiving valsartan-HCTZ. There were similar safety and tolerability data for the two active treatment groups. These findings support the use of longer-acting ARBs combined with higher doses of thiazide diuretic to improve BP control in patients with moderate-to-severe hypertension.

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Figures

Figure 1
Figure 1
Change from baseline in SBP and DBP by treatment group. (T80/H25, telmisartan 80 mg/hydrochlorothiazide 25 mg: V160/H25, valsartan 160 mg/hydrochlorothiazide 25 mg).
Figure 2
Figure 2
Proportion of patients achieving BP goal (<140/90 mm Hg), per treatment group, according to SBP at baseline (results from a logistic regression model allowing for treatment-by-baseline SBP interaction). T80/H25: telmisartan 80 mg/hydrochlorothiazide 25 mg. V160/H25:valsartan 160 mg/hydrochlorothiazide 25 mg.
Figure 3
Figure 3
Impact of age (a), gender (b), and race (c) on changes from baseline in BP by treatment group. T80/H25, telmisartan 80 mg/hydrochlorothiazide 25 mg: V160/H25, valsartan 160 mg/hydrochlorothiazide 25 mg.
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