Key result
Triple combination olmesartan, amlodipine, and hydrochlorothiazide lowers blood pressure significantly more than dual therapies.
Why the study?
The efficacy and safety of triple-combination treatment with olmesartan medoxomil, amlodipine besylate, and hydrochlorothiazide compared to dual-combination treatments in obese and nonobese hypertensive participants was assessed.
Does triple-combination therapy with olmesartan/amlodipine/hydrochlorothiazide improve blood pressure reduction compared to dual-combination therapies in obese and nonobese hypertensive patients?
RCT (n=2,492)
Double-blind
Randomized
Does triple-combination therapy with olmesartan/amlodipine/hydrochlorothiazide improve blood pressure reduction compared to dual-combination therapies in obese and nonobese hypertensive patients?
Triple-combination therapy with olmesartan, amlodipine, and hydrochlorothiazide is more effective than dual combinations for blood pressure control in both obese and nonobese hypertensive patients.
Answers are grounded in this paper and cite their sources.
Triple therapy lowers BP more than duals irrespective of obesity; extends TRINITY efficacy to BMI subgroups.
The objective of this prespecified TRINITY study subgroup analysis was to assess the efficacy and safety of triple-combination treatment with olmesartan medoxomil (OM) 40 mg, amlodipine besylate (AML) 10 mg, and hydrochlorothiazide (HCTZ) 25 mg vs the component dual-combination treatments in obese (body mass index [BMI] ≥30 kg/m(2) ) and nonobese (BMI <30 kg/m(2) ) hypertensive participants. The double-blind treatment period primary end point was the least-squares (LS) mean reduction in seated diastolic BP (SeDBP) at week 12 (end of the double-blind period). Of the 2492 randomized participants, 1555 (62.4%) had BMI ≥30 kg/m(2) . Irrespective of BMI, triple-combination treatment resulted in greater LS mean reductions in seated BP (SeBP) (≥30 kg/m(2) , 6.7-10.5/4.5-7.3 mm Hg; <30 kg/m(2) , 5.1-8.6/2.5-6.0 mm Hg [P<.005] vs dual-combination treatments for both subgroups) at week 12. Furthermore, triple-combination treatment enabled a greater proportion of participants to reach BP goal vs the dual-combination treatments (≥30 kg/m(2) , 62% vs 31%-46% [P<.0001]; <30 kg/m(2) , 69% vs 41%-55% [P<.005]) at week 12. SeBP reduction and goal attainment (≥30 kg/m(2) , 63%; <30 kg/m(2) , 67%) was maintained through week 52/early termination. Triple-combination treatment was well tolerated in both BMI subgroups.
No takes yet. Share an insight, caveat, or question.
Roth et al. (2013) conducted an RCT in Hypertension (n=2,492). Olmesartan medoxomil, amlodipine besylate, and hydrochlorothiazide vs. Component dual-combination treatments was evaluated on Least-squares mean reduction in seated diastolic BP at week 12 (p=<.005). Triple-combination treatment with olmesartan, amlodipine, and hydrochlorothiazide resulted in greater reductions in seated blood pressure compared to dual-combination treatments (P<.005).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: