Key result
Daily candesartan (8/16 mg) and hydrochlorothiazide (12.5 mg) significantly reduced clinic and ambulatory systolic blood pressure compared with placebo, with additive effects in combination.
Why the study?
Does candesartan and hydrochlorothiazide, alone or in combination, reduce systolic blood pressure in older patients with isolated systolic hypertension?
RCT (n=19)
Double-blind
Crossover
Does candesartan and hydrochlorothiazide, alone or in combination, reduce systolic blood pressure in older patients with isolated systolic hypertension?
Candesartan and hydrochlorothiazide are effective and well-tolerated for isolated systolic hypertension in older adults, providing additive blood pressure-lowering effects when combined.
Answers are grounded in this paper and cite their sources.
Supports candesartan-HCTZ combination for hypertension; confirms additive systolic BP reductions in RCT.
AIM: We investigated the efficacy and safety of daily candesartan 8/16mg and hydrochlorothiazide 12.5 mg as monotherapy and in combination in older patients with systolic hypertension. METHODS: The study used a double-blind randomized placebo-controlled crossover design. Treatment phases were of 6 weeks duration. For inclusion, patients were aged 55-84 years with sitting systolic blood pressure (SBP) 160-210 mmHg and diastolic blood pressure (DBP) < 95 mmHg. Nineteen patients (11 male, eight female, median age 68 years) completed the study. MAJOR FINDINGS: Compared with the placebo phase, clinic and ambulatory SBP was significantly reduced with both dose-adjusted candesartan and fixed-dose hydrochlorothiazide as monotherapy, the effect of candesartan being greater than that of hydrochlorothiazide. In combination, the effects of the two drugs were additive. Both drugs were well tolerated either as monotherapy or in combination. CONCLUSION: Both candesartan and a low dose of hydrochlorothiazide are effective and well-tolerated antihypertensive agents in isolated systolic hypertension with additive effects in combination. Candesartan was more effective than hydrochlorothiazide, although it is possible that dose adjustment only of candesartan could have enhanced its relative effectiveness.
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Wing et al. (2003) conducted an RCT in Isolated systolic hypertension (n=19). Candesartan and hydrochlorothiazide vs. Placebo was evaluated on Clinic and ambulatory systolic blood pressure. Daily candesartan (8/16 mg) and hydrochlorothiazide (12.5 mg) significantly reduced clinic and ambulatory systolic blood pressure compared with placebo, with additive effects in combination.
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