What question did this study set out to answer?

To evaluate the efficacy and safety of adding benazepril or hydrochlorothiazide in patients with essential hypertension unresponsive to valsartan monotherapy.

November 1, 2001Journal of Hypertension

Combination of hydrochlorothiazide or benazepril with valsartan in hypertensive patients unresponsive to valsartan alone

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Why the study?

Does the addition of hydrochlorothiazide or benazepril improve blood pressure reduction in hypertensive patients unresponsive to valsartan alone?

Population

327 patients with mild to moderate essential hypertension, of which 174 were unresponsive to 4 weeks of…

Comparison

Addition of hydrochlorothiazide 12.5 mg/day to… vs Addition of benazepril 10 mg/day to valsartan 80…

Design

RCT, Randomized to either the valsartan-hydrochlorothiazide or the…

Follow-up

4 weeks

Authors

BWBernard WaeberUniversity of Lausanne RARolf Aschwanden LSLadislav Sadecky

Discussion

Member takes

Implication

Favors hydrochlorothiazide over benazepril as add-on to valsartan in nonresponders; extends evidence for preferred combinations in resistant hypertension.

Key Points

To evaluate the efficacy and safety of adding benazepril or hydrochlorothiazide in patients with essential hypertension unresponsive to valsartan monotherapy.
Open multicenter study of 327 patients with mild to moderate essential hypertension treated with valsartan (80 mg/day) for 4 weeks.
Patients with diastolic blood pressure > 90 mmHg after 4 weeks were randomized to receive 4 weeks of either valsartan plus hydrochlorothiazide (12.5 mg/day) or valsartan plus benazepril (10 mg/day).
Responders to valsartan monotherapy (n=153, 46%) continued the same regimen for an additional 4 weeks.
Both combination therapies achieved additional diastolic blood pressure reductions (-4.5 mmHg with hydrochlorothiazide vs. -3.3 mmHg with benazepril).
Systolic blood pressure reduction was greater with valsartan plus hydrochlorothiazide (-6.77 mmHg) than with valsartan plus benazepril (-3.2 mmHg).
Valsartan monotherapy and both combination regimens were well tolerated with no reported safety concerns.

Structured PICO

Does the addition of hydrochlorothiazide or benazepril improve blood pressure reduction in hypertensive patients unresponsive to valsartan alone?

Population

327 patients with mild to moderate essential hypertension, of which 174 were unresponsive to 4 weeks of valsartan 80 mg/day monotherapy (diastolic BP > 90 mmHg) and subsequently randomized.

Intervention

Addition of hydrochlorothiazide 12.5 mg/day to valsartan 80 mg/day for 4 weeks

Comparator

Addition of benazepril 10 mg/day to valsartan 80 mg/day for 4 weeks

Outcome

Reduction in diastolic and systolic blood pressuresurrogate

In hypertensive patients unresponsive to valsartan monotherapy, adding hydrochlorothiazide is more effective than adding benazepril for reducing systolic blood pressure.

Cite This Study

Waeber et al. (2001) studied this question.

synapsesocial.com/papers/6a6fbb5326a7f98052dc5692 https://doi.org/10.1097/00004872-200111000-00022

Topics

Hypertension management

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Implication

Favors hydrochlorothiazide over benazepril as add-on to valsartan in nonresponders; extends evidence for preferred combinations in resistant hypertension.

Combination of hydrochlorothiazide or benazepril with valsartan in hypertensive patients unresponsive to valsartan alone

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Combination of hydrochlorothiazide or benazepril with valsartan in hypertensive patients unresponsive to valsartan alone

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider