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The ‘pyrrhic victory’ of amlodipine over hydrochlorothiazide in the OLAS study: response from the authors

Journal of Human Hypertension volume 25, pages 403–404 (2011)Cite this article

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The current European guidelines for the management of hypertension1 state that lifestyle measures should be instituted in all hypertensive patients; however, the long-term compliance with their implementation is notoriously low. All our patients receive lifestyle counseling according to good practice guidelines. However the OLAS study2 was focused in the comparison of two pharmacological treatments and not on the relative merits of lifestyle and medication.

As Thomopoulos et al.3 point out, no reduction in body mass index or waist circumference was achieved in our study. It cannot be concluded, though, that the overall cardiovascular risk of our patients was not reduced, as large reductions in blood pressure and albuminuria were attained in both treatment arms. The patients receiving olmesartan/amlodipine showed better metabolic and anti-inflammatory effects than their olmesartán/hydrocholothiazide counterparts. It is still unknown whether these effects may reduce further their cardiovascular risk, but in the ACCOMPLISH trial,4 with a similar treatment strategy, a highly significant reduction in cardiovascular mortality and morbidity was observed with the benazepril/amlodipine combination compared with the benazepril/hydrochlorothiazide combination. This difference could only be attributed to the effects of medication and not to lifestyle changes.

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References

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  1. Endocrinology Department, Outpatient Hypertension Clinic, Hospital Universitario Dr Negrin, Barranco de la Ballena, Las Palmas de Gran Canaria, Spain

    F J Martinez-Martin

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  1. F J Martinez-Martin
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Correspondence to F J Martinez-Martin.

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Martinez-Martin, F., on behalf of the OLAS authors. The ‘pyrrhic victory’ of amlodipine over hydrochlorothiazide in the OLAS study: response from the authors. J Hum Hypertens 25, 403–404 (2011). https://doi.org/10.1038/jhh.2011.15

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