Jean-Jacques Mourad1, Sylvain Le Jeune. 1. Assistance Publique-Hôpitaux de Paris, Avicenne Hospital and University Paris XIII, Bobigny, France. jean-jacques.mourad@avc.aphp.fr
Abstract
BACKGROUND AND OBJECTIVE:Systolic blood pressure (SBP) strongly predicts cardiovascular risk and is an important factor to evaluate in studies of antihypertensive treatments. A recent randomized controlled study has shown that the angiotensin II type 1 receptor antagonist (angiotensin receptor blocker [ARB]) olmesartan medoxomil (hereafter olmesartan) combined with the calcium channel antagonist (calcium channel blocker) amlodipine can control SBP in a majority of patients with moderate-to-severe hypertension. The aim of this report is to present results from a post hoc analysis of this study to further evaluate the effects of this combination on SBP. METHODS: A post hoc analysis of changes in seated SBP (SeSBP) levels in patients treated with olmesartan 40 mg plus amlodipine 5 or 10 mg was carried out to investigate the distribution of SeSBP changes produced by this combination. Patients who reached the end of the 52-week study were categorized by size of SeSBP reduction from baseline as follows: </=15 mmHg; >15 to </=30 mmHg; >30 to </=45 mmHg and >45 mmHg. RESULTS: In 578 patients who receivedolmesartan/amlodipine 40 mg/5 mg or 40 mg/10 mg and completed the study, the mean SeSBP reduction from baseline was 31.18 mmHg, and the proportions of patients with SeSBP reductions </=15 mmHg, >15 to </=30 mmHg, >30 to </=45 mmHg and >45 mmHg were 12.8%, 36.0%, 35.3% and 15.9%, respectively. In patients who received olmesartan/amlodipine 40 mg/10 mg, the proportion of patients in the </=15 mmHg group was smaller (12.2%) and in the >45 mmHg group was larger (21.6%). Moreover, patients in the >45 mmHg category showed the greatest reduction in SeSBP from baseline (53.5 mmHg for olmesartan/amlodipine 40 mg/10 mg recipients). Categorical analysis of patients treated with olmesartan/amlodipine 40 mg/10 mg in a separate, factorial study showed similar results: SeSBP reductions of </=15 mmHg; >15 to </=30 mmHg; >30 to </=45 mmHg and >45 mmHg were seen in 17%, 34%, 36% and 14% of patients, respectively. CONCLUSION: Treatment with a combination based upon olmesartan 40 mg plus amlodipine 5 or 10 mg effectively reduces elevated SeSBP, particularly in patients with high levels of SeSBP.
RCT Entities:
BACKGROUND AND OBJECTIVE: Systolic blood pressure (SBP) strongly predicts cardiovascular risk and is an important factor to evaluate in studies of antihypertensive treatments. A recent randomized controlled study has shown that the angiotensin II type 1 receptor antagonist (angiotensin receptor blocker [ARB]) olmesartanmedoxomil (hereafter olmesartan) combined with the calcium channel antagonist (calcium channel blocker) amlodipine can control SBP in a majority of patients with moderate-to-severe hypertension. The aim of this report is to present results from a post hoc analysis of this study to further evaluate the effects of this combination on SBP. METHODS: A post hoc analysis of changes in seated SBP (SeSBP) levels in patients treated with olmesartan 40 mg plus amlodipine 5 or 10 mg was carried out to investigate the distribution of SeSBP changes produced by this combination. Patients who reached the end of the 52-week study were categorized by size of SeSBP reduction from baseline as follows: </=15 mmHg; >15 to </=30 mmHg; >30 to </=45 mmHg and >45 mmHg. RESULTS: In 578 patients who received olmesartan/amlodipine 40 mg/5 mg or 40 mg/10 mg and completed the study, the mean SeSBP reduction from baseline was 31.18 mmHg, and the proportions of patients with SeSBP reductions </=15 mmHg, >15 to </=30 mmHg, >30 to </=45 mmHg and >45 mmHg were 12.8%, 36.0%, 35.3% and 15.9%, respectively. In patients who received olmesartan/amlodipine 40 mg/10 mg, the proportion of patients in the </=15 mmHg group was smaller (12.2%) and in the >45 mmHg group was larger (21.6%). Moreover, patients in the >45 mmHg category showed the greatest reduction in SeSBP from baseline (53.5 mmHg for olmesartan/amlodipine 40 mg/10 mg recipients). Categorical analysis of patients treated with olmesartan/amlodipine 40 mg/10 mg in a separate, factorial study showed similar results: SeSBP reductions of </=15 mmHg; >15 to </=30 mmHg; >30 to </=45 mmHg and >45 mmHg were seen in 17%, 34%, 36% and 14% of patients, respectively. CONCLUSION: Treatment with a combination based upon olmesartan 40 mg plus amlodipine 5 or 10 mg effectively reduces elevated SeSBP, particularly in patients with high levels of SeSBP.
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