Key result
Zofenopril plus hydrochlorothiazide achieved similar office blood pressure response rates compared to irbesartan plus hydrochlorothiazide (68% vs 70%; p=0.778) in high-risk hypertensives.
Why the study?
Does zofenopril plus hydrochlorothiazide improve blood pressure response compared to irbesartan plus hydrochlorothiazide in high-risk hypertensives uncontrolled by monotherapy?
RCT (n=434)
double-blind
randomized
Does zofenopril plus hydrochlorothiazide improve blood pressure response compared to irbesartan plus hydrochlorothiazide in high-risk hypertensives uncontrolled by monotherapy?
Absolute Event Rate: 68% vs 70%
p-value: p=0.778
Zofenopril plus hydrochlorothiazide is as effective as irbesartan plus hydrochlorothiazide in reducing blood pressure and target organ damage in high-risk hypertensives uncontrolled by monotherapy.
Zofenopril-hydrochlorothiazide provides a comparable option to irbesartan-hydrochlorothiazide in high-risk hypertension; confirms similar office BP control in this RCT.
In this randomized, double-blind, controlled, parallel group study (ZENITH), 434 essential hypertensives with additional cardiovascular risk factors, uncontrolled by a previous monotherapy, were treated for 18 weeks with zofenopril 30 or 60 mg plus hydrochlorothiazide (HCTZ) 12.5 mg or irbesartan 150 or 300 mg plus HCTZ. Rate of office blood pressure (BP) response (zofenopril: 68% versus irbesartan: 70%; p = 0.778) and 24-hour BP response (zofenopril: 85% versus irbesartan: 84%; p = 0.781) was similar between the two treatment groups. Cardiac and renal damage was equally reduced by both treatments, whereas the rate of carotid plaque regression was significantly larger with zofenopril. In conclusion, uncontrolled monotherapy treated hypertensives effectively respond to a combination of zofenopril or irbesartan plus a thiazide diuretic, in terms of either BP response or target organ damage progression.
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Malacco et al. (2015) conducted an RCT in essential hypertension (n=434). Zofenopril plus hydrochlorothiazide vs. Irbesartan 150 or 300 mg plus HCTZ was evaluated on Rate of office blood pressure response (p=0.778). Zofenopril plus hydrochlorothiazide achieved similar office blood pressure response rates compared to irbesartan plus hydrochlorothiazide (68% vs 70%; p=0.778) in high-risk hypertensives.
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