Abstract
The antihypertensive effects of telmisartan 80 mg versus valsartan 160 mg, both combined with hydrochlorothiazide (HCTZ) 25 mg, were assessed in a pooled analysis from two large trials with identical study designs in patients with stage 1–2 hypertension. The trials were double-blind with a 4:4:1 randomization scheme to compare once-daily telmisartan 80 mg and HCTZ 25 mg versus once-daily valsartan 160 mg and HCTZ 25 mg versus once-daily placebo on reductions in clinic blood pressure (BP). The primary end point was changes from baseline in BP at the end of 8 weeks. In total, 2121 patients were randomized (telmisartan–HCTZ, 942, valsartan–HCTZ, 952, and placebo, 227) and had baseline seated BPs of 154/102 and 155/102 mm Hg in the two studies, respectively. Changes from baseline in BP after administration of telmisartan–HCTZ (−24.5/−18.0 mm Hg) were significantly greater than for both placebo (−4.1/−6.5 mm Hg) and valsartan–HCTZ (−22.3/−16.8 mm Hg) (versus placebo, P<0.0001 for systolic and diastolic BP; versus valsartan–HCTZ, P=0.0004 for systolic BP and P=0.0019 for diastolic BP). Adverse event rates were higher in the placebo group than in the active treatment groups (placebo, 41%, telmisartan–HCTZ, 30%, and valsartan–HCTZ, 30%, P<0.05). These data confirm that telmisartan–HCTZ at doses of 80/25 mg lowered systolic and diastolic BP to a greater extent than valsartan–HCTZ at doses of 160/25 mg in stage 1–2 hypertension. The magnitude of the BP-lowering effect provides support for the use of angiotensin receptor blockers with higher doses of a thiazide diuretic (25 mg) to improve hypertension control.
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White, W., Davidai, G. & Schumacher, H. Impact of angiotensin receptor blockade in combination with hydrochlorothiazide 25 mg in 2121 patients with stage 1–2 hypertension. J Hum Hypertens 23, 817–825 (2009). https://doi.org/10.1038/jhh.2009.28
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DOI: https://doi.org/10.1038/jhh.2009.28
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