1. ¹Orange County Research Center, Tustin, CA, USA
2. ²Integrium, Tustin, CA, USA
3. ³Memorial Research Medical Clinic, Long Beach, CA, USA
4. ⁴Sankyo Pharma Inc., Parsippany, NJ, USA
5. ⁵Forest Research Institute, Jersey City, NJ, USA
6. ⁶State University of New York Downstate College of Medicine, Brooklyn, NY, USA

Correspondence: Dr JM Neutel, Orange County Research Center, 14351 Myford Road, Tustin, CA 92780, USA. E-mail: JMNeutel@aol.com

Received 30 March 2005; Revised 27 September 2005; Accepted 2 October 2005; Published online 5 January 2006.

Abstract

This study analysed the efficacy of an angiotensin receptor blocker-based treatment algorithm for achieving goal blood pressure (BP) in patients with stage 1 (systolic BP (SBP) 140–159 mmHg or diastolic BP (DBP) 90–99 mmHg) or stage 2 (SBP 160 mmHg or DBP 100 mmHg) hypertension. In this 24-week, open-label, multicentre study, patients followed a six-step algorithm until goal BP (130/85 mmHg) was attained. Initially, olmesartan medoxomil 20 mg/day was administered for 4 weeks. The regimen was modified every 4 weeks until goal BP was attained: increase olmesartan medoxomil to 40 mg/day; add hydrochlorothiazide (HCTZ) 12.5 mg/day; increase HCTZ to 25 mg/day; add amlodipine besylate 5 mg/day; increase amlodipine besylate to 10 mg/day. In patients with stage 1 hypertension, 80% (63/79) and 56% (44/79) achieved BP goals of 140/90 mmHg and 130/85 mmHg, respectively, with olmesartan medoxomil monotherapy (94% (74/79) and 89% (70/79) with olmesartan medoxomil/HCTZ double therapy, and 96% (76/79) and 98% (77/79) with addition of amlodipine besylate (triple therapy)). Mean SBP/DBP reductions were 16.7/11.6, 24.8/15.8, and 26.4/16.5 mmHg for mono-, double-, and triple-therapy, respectively. In patients with stage 2 hypertension, 42% (42/100) and 19% (19/100) achieved BP goals of 140/90 mmHg and 130/85 mmHg, respectively, with monotherapy (75% (75/100) and 54% (54/100) with double therapy, and 90% (90/100) and 81% (81/100) with triple-therapy). Mean SBP/DBP reductions in stage 2 patients were 18.4/10.0, 32.7/16.3, and 39.1/19.4 mmHg for mono-, double, and triple therapy, respectively. Overall, most patients with stage 1 or stage 2 hypertension achieved goal BP.