July 24, 2012Journal of Hypertension
Clinic and ambulatory blood pressure lowering effect of aliskiren/amlodipine/hydrochlorothiazide combination in patients with moderate-to-severe hypertension
Key result
Aliskiren/amlodipine/hydrochlorothiazide triple therapy provided superior reductions in mean sitting SBP/DBP (-37.9/-20.6 mmHg at week 8) versus dual combinations (P<0.001).
Why the study?
Does aliskiren/amlodipine/hydrochlorothiazide triple combination improve blood pressure reduction compared to dual combinations in patients with moderate-to-severe hypertension?
Population
1191 patients with moderate-to-severe hypertension
Comparison
Aliskiren/amlodipine/hydrochlorothiazide triple… vs Dual combinations once-daily…
Design
RCT, randomized, double-blind
Follow-up
8 weeks
Authors
Discussion
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Implication
Supports triple therapy over duals for moderate-to-severe hypertension; extends RCT evidence for aliskiren-based regimens.
Study Design
Type
RCT (n=1,191)
Blinding
Double-blind
Randomization
randomized
Structured PICO
Does aliskiren/amlodipine/hydrochlorothiazide triple combination improve blood pressure reduction compared to dual combinations in patients with moderate-to-severe hypertension?
P
Population
1191 patients with moderate-to-severe hypertension
I
Intervention
Aliskiren/amlodipine/hydrochlorothiazide (HCT) triple combination once-daily (150/5/12.5 mg for 4 weeks, followed by forced titration to 300/10/25 mg for the next 4 weeks)
C
Comparator
Dual combinations once-daily: aliskiren/amlodipine (150/5 mg up-titrated to 300/10 mg), aliskiren/HCT (150/12.5 mg up-titrated to 300/25 mg), or amlodipine/HCT (5/12.5 mg up-titrated to 10/25 mg)
O
Outcome
Reduction in mean sitting SBP and DBP (msSBP/msDBP) from baseline to endpoints (week 4 and week 8)surrogate
Main Result
p-value: p=<0.001
Triple therapy with aliskiren/amlodipine/HCT provides superior blood pressure reduction and control compared to dual combinations in patients with moderate-to-severe hypertension.
Cite This Study
Lacourcière et al. (2012) conducted an RCT in moderate-to-severe hypertension (n=1,191). aliskiren/amlodipine/hydrochlorothiazide vs. aliskiren/amlodipine, aliskiren/HCT, or amlodipine/HCT dual combinations was evaluated on reduction in mean sitting SBP and DBP from baseline to week 8 (p=<0.001). Aliskiren/amlodipine/hydrochlorothiazide triple therapy provided superior reductions in mean sitting SBP/DBP (-37.9/-20.6 mmHg at week 8) versus dual combinations (P<0.001).