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Title: Effectiveness of open-label losartan/hydrochlorothiazide combination therapy in Asian patients with hypertension not controlled with ACE inhibitor or ARB monotherapy
Authors: Kee Sik Kim
Wei Hu Fan
Young Dae Kim
Wenling Zhu
Yen Yew Ngau
Peter Tong
Byung Soo Kim
Maureen Santos
Wei Hsiang Lin
Peera Buranakitjaroen
Rachid Massaad
Ronald D. Smith
Catholic University of Daegu
Huashan Hospital
Dong-A University, College of Medicine
Peking Union Medical College
Kuala Lumpur Hospital
Prince of Wales Hospital Hong Kong
Daedong Hospital
Cebu Doctors' University Hospital
Triservice General Hospital Taiwan
Mahidol University
MSD (Europe) Inc.
Merck & Co., Inc.
Keywords: Biochemistry, Genetics and Molecular Biology;Medicine
Issue Date: 12-Aug-2009
Citation: Hypertension Research. Vol.32, No.6 (2009), 520-526
Abstract: Antihypertensive efficacy and safety of losartan/hydrochlorothiazide (HCTZ) combinations have not been adequately studied in Asians. In this open-label, 12-week study in seven Asian areas, patients on monotherapy with angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) but not at blood pressure (BP) goal (sitting diastolic BP (SiDBP) <90 mm Hg in non-diabetics and <80 mm Hg in diabetics) were switched to losartan 50 mg/HCTZ 12.5 mg. At 4 and 8 weeks, the therapy for patients not at goal BP was titrated to losartan 100 mg/HCTZ 12.5 mg and to losartan 100 mg/HCTZ 25 mg, respectively. Data analysis included 430 patients with mean (s.d.) age 53.0 (10.1) years and 51.9% of the female gender. After 8 weeks (primary end point; titration up to losartan 100 mg/HCTZ 12.5 mg), 73.5% (95% confidence interval (CI): 69.0-77.6) of patients reached BP goal; 63.4 and 78.1% of patients reached BP goal at 4 weeks (titration up to losartan 50 mg/HCTZ 12.5 mg) and at 12 weeks (titration up to losartan 100 mg/HCTZ 25 mg). The mean changes from baseline (95% CI) in sitting systolic BP and SiDBP at 8 weeks were -16.7 (-18.0 to -15.4) mm Hg and -12.1 (-12.9 to -11.4) mm Hg, respectively. Clinical and laboratory adverse experiences (AEs) were reported in 27.5 and 21.0% of patients, respectively. Nine patients were discontinued because of drug-related clinical AEs. Switching Asian patients currently not at BP goal with ARB or ACEI monotherapy to a losartan/HCTZ combination achieved BP goal in the majority of patients. Losartan/HCTZ combinations were generally well tolerated.
ISSN: 13484214
Appears in Collections:Scopus 2006-2010

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