Key result
Switching to a daily ARB/diuretic combination (hydrochlorothiazide 6.25 mg/candesartan 8 mg) for 24 weeks significantly reduced blood pressure and improved BNP levels in chronic heart failure.
Why the study?
Does replacing RAAS inhibitors with a hydrochlorothiazide/candesartan combination improve blood pressure and BNP in patients with stabilized chronic heart failure and hypertension?
Observational (n=61)
Open-label
Does replacing RAAS inhibitors with a hydrochlorothiazide/candesartan combination improve blood pressure and BNP in patients with stabilized chronic heart failure and hypertension?
Switching to a candesartan/hydrochlorothiazide combination effectively lowers blood pressure and improves BNP in patients with chronic heart failure and uncontrolled hypertension.
Answers are grounded in this paper and cite their sources.
Should not yet change practice in chronic HF; hypothesis-generating for ARB/diuretic combinations pending randomized trials.
The effects of 24 weeks' treatment with an angiotensin 2 receptor blocker (ARB)/diuretic combination drug were investigated in an open-label study of 61 patients with stabilized chronic heart failure. Renin-angiotensin-aldosterone system inhibitors were replaced with a tablet containing hydrochlorothiazide 6.25 mg plus candesartan 8 mg, administered orally, once daily, in patients with systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg while under optimal treatment. Both SBP and DBP declined significantly during the ARB/diuretic combination treatment. Diuretics administered previously were discontinued during the study period in 15 patients, decreasing the number of drugs being taken. During ARB/diuretic combination treatment, the blood urea nitrogen level worsened but no significant changes were noted in potassium or estimated glomerular filtration rate, which had been a matter of concern. Additionally, the level of brain natriuretic peptide, an indicator of the severity of heart failure, was improved, indicating effectiveness and safety of the ARB/diuretic combination drug.
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Suzuki et al. (2011) conducted an observational in Chronic heart failure complicated by hypertension (n=61). ARB/diuretic combination (hydrochlorothiazide plus candesartan) vs. Previous renin-angiotensin-aldosterone system inhibitors was evaluated on Blood pressure and brain natriuretic peptide levels. Switching to a daily ARB/diuretic combination (hydrochlorothiazide 6.25 mg/candesartan 8 mg) for 24 weeks significantly reduced blood pressure and improved BNP levels in chronic heart failure.
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