Key result
Valsartan/hydrochlorothiazide reduced ambulatory systolic/diastolic BP more effectively than amlodipine/hydrochlorothiazide in Caucasians (-21.9/-12.7 vs -17.6/-9.5 mm Hg; P=.0004/P<.0001).
Why the study?
Does valsartan/hydrochlorothiazide reduce ambulatory blood pressure more effectively than amlodipine/hydrochlorothiazide in different ethnic groups with stage 2 hypertension?
RCT (n=421)
Does valsartan/hydrochlorothiazide reduce ambulatory blood pressure more effectively than amlodipine/hydrochlorothiazide in different ethnic groups with stage 2 hypertension?
Valsartan/HCTZ is more effective than amlodipine/HCTZ in lowering ambulatory BP in Caucasians with stage 2 hypertension, but both regimens are similarly effective in African Americans and Hispanics.
Answers are grounded in this paper and cite their sources.
Supports preferring valsartan/HCTZ in Caucasians; extends evidence of ethnic differences in antihypertensive response.
Several studies reported racial/ethnic differences in blood pressure (BP) response to antihypertensive monotherapy. In a 10-week study of stage 2 hypertension, 320/25 mg valsartan/hydrochlorothiazide (HCTZ) reduced ambulatory BP (ABP) significantly more effectively than 10/25 mg amlodipine/HCTZ. Results (post hoc analysis) are described in Caucasians (n=256), African Americans (n=79), and Hispanics (n=86). Compared with clinic-measured BP (no significant treatment-group differences in ethnic subgroups), least-squares mean reductions from baseline to week 10 in mean ambulatory systolic BP (MASBP) and mean ambulatory diastolic BP (MADBP) favored valsartan/HCTZ over amlodipine/HCTZ in Caucasians (-21.9/-12.7 mm Hg vs -17.6/-9.5 mm Hg; P=.0004/P<.0001). No treatment-group differences in MASBP/MADBP were observed in African Americans (-17.3/-10.6 vs -17.9/-9.5; P=.76/P=.40) or Hispanics (-17.9/-9.7 vs -14.2/-7.2; P=.20/P=.17). Based on ABP monitoring, valsartan/HCTZ is more effective than amlodipine/HCTZ in lowering ABP in Caucasians. In African Americans and Hispanics, both regimens are similarly effective.
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Wright et al. (2010) conducted an RCT in Stage 2 hypertension (n=421). Valsartan/hydrochlorothiazide vs. Amlodipine/hydrochlorothiazide (10/25 mg) was evaluated on Mean ambulatory systolic BP (MASBP) reduction from baseline to week 10 in Caucasians (p=.0004). Valsartan/hydrochlorothiazide reduced ambulatory systolic/diastolic BP more effectively than amlodipine/hydrochlorothiazide in Caucasians (-21.9/-12.7 vs -17.6/-9.5 mm Hg; P=.0004/P<.0001).
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