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Clinical Trial
. 2013 Apr;15(4):247-53.
doi: 10.1111/jch.12060. Epub 2013 Feb 1.

Efficacy/safety of a fixed-dose amlodipine/olmesartan medoxomil-based treatment regimen in hypertensive blacks and non-blacks with uncontrolled BP on prior antihypertensive monotherapy

Shawna Nesbitt  1 , Ali Shojaee, Jen-Fue Maa
Affiliations
Clinical Trial

Efficacy/safety of a fixed-dose amlodipine/olmesartan medoxomil-based treatment regimen in hypertensive blacks and non-blacks with uncontrolled BP on prior antihypertensive monotherapy

Shawna Nesbitt et al. J Clin Hypertens (Greenwich). 2013 Apr.

Abstract

In this secondary analysis of a dose-titration study of patients with hypertension uncontrolled on prior monotherapy, blacks (n=234) and non-blacks (n=765) were switched to amlodipine (AML)/olmesartan medoxomil (OM) 5/20 mg, with uptitration every 4 weeks to AML/OM 5/40 mg and then AML/OM 10/40 mg to achieve a seated cuff blood pressure (SeBP) of <120/70 mm Hg. Hydrochlorothiazide 12.5 and 25 mg could be added if SeBP was ≥125/75 mm Hg. The cumulative proportions of patients achieving systolic SeBP <140 mm Hg (<130 mm Hg if diabetic) at 12 weeks were 71.6% for blacks and 77.2% for non-blacks. Mean SeBP change from baseline in blacks (mean baseline BP: 153.0/93.7 mm Hg) ranged from -11.7/-6.1 mm Hg for AML/OM 5/20 mg to -23.6/-12.9 mm Hg for AML/OM 10/40 mg +hydrochlorothiazide 25 mg (all P<.0001). Antihypertensive efficacy was maintained throughout the 24-hour dosing interval. An AML/OM-based regimen was effective in blacks with hypertension uncontrolled on prior monotherapy.

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Figures

Figure 1
Figure 1
Study design. AML indicates, amlodipine; HCTZ, hydrochlorothiazide; OM, olmesartan medoxomil. aScheduled ambulatory blood pressure monitoring (ABPM) measurement for ABPM cohort. Reprinted from Neutel J, Shojaee A, Maa J‐F. Efficacy of amlodipine/olmesartan ± hydrochlorothiazide in patients uncontrolled on prior calcium channel blocker or angiotensin II receptor blocker monotherapy. Adv Ther. 2012;29(6):508–523, with kind permission from Springer Science+Business Media B.V.
Figure 2
Figure 2
Mean±standard error change from baseline in seated cuff systolic blood pressure (SeSBP) and seated cuff diastolic blood pressure (SeDBP) at the end of each titration dose period in (A) blacks and (B) non‐blacks. AML indicates amlodipine; HCTZ, hydrochlorothiazide; OM, olmesartan medoxomil; SeBP, seated cuff blood pressure.
Figure 3
Figure 3
Cumulative proportions of blacks and non‐blacks achieving the seated cuff blood pressure (SeBP) threshold of <140/90 mm Hg by titration dose. AML indicates amlodipine; HCTZ, hydrochlorothiazide; OM, olmesartan medoxomil.
Figure 4
Figure 4
Mean change from baseline in mean 24‐hour ambulatory blood pressure (BP) at (a) week 12 and (b) week 20 in blacks and non‐blacks. DBP indicates diastolic BP; SBP, systolic BP.
Figure 5
Figure 5
Mean hourly ambulatory systolic blood pressure (SBP) at baseline, week 12, and week 20 in (a) blacks and (b) non‐blacks.
See this image and copyright information in PMC

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