Key result
Adding hydrochlorothiazide to olmesartan/amlodipine produced greater reductions in seated blood pressure compared with dual therapy across all subgroups (P<.05).
Why the study?
Does adding hydrochlorothiazide to olmesartan/amlodipine dual therapy improve blood pressure reduction in patients with moderate to severe hypertension?
RCT (n=2,690)
Double-blind
Does adding hydrochlorothiazide to olmesartan/amlodipine dual therapy improve blood pressure reduction in patients with moderate to severe hypertension?
p-value: p=<.05
Adding hydrochlorothiazide to olmesartan/amlodipine dual therapy significantly improves blood pressure reduction in patients with moderate to severe hypertension, regardless of age, sex, or obesity.
Supports triple therapy in moderate-severe hypertension; extends dual-therapy evidence across subgroups.
This prespecified subgroup analysis of a phase III study examined the effect of adding hydrochlorothiazide (HCTZ) to olmesartan (OLM)/amlodipine (AML) in patients with moderate to severe hypertension stratified by age, sex, body mass index, and hypertension severity. A total of 2690 patients, aged 18 years and older, with seated blood pressure (SeBP) ≥160/100 mm Hg received placebo or OLM/AML 20/5 mg, 40/5 mg, or 40/10 mg during a 2-week, double-blind, run-in period, after which they were allocated to one of eight treatment groups with the same OLM/AML dose or with HCTZ 12.5 mg or 25 mg added for 8 weeks. By week 10, greater reductions in SeBP were observed in each OLM/AML/HCTZ group (P<.05, respectively) compared with the corresponding dual dose. Adding HCTZ increased blood pressure-lowering efficacy in all subgroups, with a higher proportion of blood pressure goal achievement vs dual therapy. OLM/AML/HCTZ reduced SeBP to a greater extent than OLM/AML in patients with moderate to severe hypertensive; this was unaffected by baseline hypertension severity, age, sex, and obesity.
No takes yet. Share an insight, caveat, or question.
Kreutz et al. (2014) conducted an RCT in Moderate to severe hypertension (n=2,690). Olmesartan, amlodipine, and hydrochlorothiazide (OLM/AML/HCTZ) vs. Olmesartan/amlodipine (OLM/AML) dual therapy was evaluated on Reduction in seated blood pressure (p=<.05). Adding hydrochlorothiazide to olmesartan/amlodipine produced greater reductions in seated blood pressure compared with dual therapy across all subgroups (P<.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: