Key result
Irbesartan/HCTZ is linked to a ~7 mm Hg greater systolic BP reduction than valsartan/HCTZ.
Why the study?
Comparative data on blood pressure control between irbesartan/hydrochlorothiazide and valsartan/hydrochlorothiazide combinations in patients at a tertiary care hospital in Oman were lacking.
Does irbesartan/hydrochlorothiazide improve blood pressure reduction compared to valsartan/hydrochlorothiazide in patients requiring antihypertensive therapy?
Observational (n=232)
No
Does irbesartan/hydrochlorothiazide improve blood pressure reduction compared to valsartan/hydrochlorothiazide in patients requiring antihypertensive therapy?
Absolute Event Rate: -9% vs -2%
p-value: p=0.021
Irbesartan/hydrochlorothiazide may provide greater blood pressure reduction than valsartan/hydrochlorothiazide, particularly in diabetic patients, though baseline imbalances in this retrospective cohort limit causal inference.
May support irbesartan/HCTZ preference in select patients; leaves open causal confirmation and practice change pending RCTs.
OBJECTIVE: To compare blood pressure (BP) control in patients receiving irbesartan/hydrochlorothiazide (HCTZ) and valsartan/HCTZ at a tertiary care university hospital in Oman. SUBJECTS AND METHODS: This was a retrospective observational study, where 232 patients' medical records were reviewed during a 3-month period, July to September 2010, at Sultan Qaboos University Hospital in Oman. BP readings of the previous 6 months were also retrieved from the electronic medical records. Analyses were conducted using univariate statistical techniques. RESULTS: The mean age of the cohort was 58 ± 11 years (range: 21-88). Sixty-nine (30%) patients were on the irbesartan/HCTZ combination (150/12.5 mg) and 163 (70%) were on the valsartan/HCTZ combination. The patients on the valsartan/HCTZ combination were divided into two subgroups: 117 (72%) received 160/12.5 mg and 46 (28%) 80/12.5 mg. Diabetic patients (43/69, 62%, vs. 61/163, 37%, p < 0.001) and those with diabetic nephropathy (8/69, 12%, vs. 7/163, 4%, p = 0.039) were prescribed more often irbesartan/HCTZ than valsartan/HCTZ. In comparison to the valsartan/HCTZ cohort, the irbesartan/HCTZ group was associated with significant reductions in both systolic BP (SBP; -9 vs. -2 mm Hg; p = 0.021) and diastolic BP (DBP; -5 vs. 0 mm Hg; p = 0.022). BP reductions were noted more in diabetics than nondiabetics with the irbesartan/HCTZ patients associated with significant reductions in both SBP (-12 vs. 5.1 mm Hg; p < 0.001) and DBP (-6.4 vs. 1.9 mm Hg; p = 0.001). CONCLUSIONS: The irbesartan/HCTZ combination was associated with significant reductions in both SBP and DBP when compared with the valsartan/HCTZ combination. Specifically, the reductions were noted more in diabetics than nondiabetics.
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Habib et al. (2012) conducted an observational in Hypertension (n=232). Irbesartan/hydrochlorothiazide vs. Valsartan/hydrochlorothiazide (160/12.5 mg or 80/12.5 mg) was evaluated on Reduction in systolic blood pressure (mm Hg) (p=0.021). Irbesartan/hydrochlorothiazide was associated with significantly greater reductions in systolic (-9 vs. -2 mm Hg; p=0.021) and diastolic (-5 vs. 0 mm Hg; p=0.022) blood pressure than valsartan/HCTZ.
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