Aliskiren and valsartan in stage 2 hypertension: subgroup analysis of a randomized, double-blind study

Introduction Patients with stage 2 hypertension require large absolute reductions in blood pressure (BP) to achieve recommended BP goals. Combination therapy with the direct renin inhibitor, aliskiren, and the angiotensin receptor blocker, valsartan, has been shown to produce greater BP reductions t...

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Bibliographic Details
Published in:Advances in therapy 2008-12, Vol.25 (12), p.1288-1302
Main Authors: Yarows, Steven A., Oparil, Suzanne, Patel, Samir, Fang, Hui, Zhang, Jack
Format: Article
Language:English
Subjects:
Aged
Amides - adverse effects
Amides - therapeutic use
Antihypertensive Agents - administration & dosage
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Cardiology
Double-Blind Method
Drug Therapy, Combination
Endocrinology
Female
Fumarates - adverse effects
Fumarates - therapeutic use
Humans
Hypertension - drug therapy
Internal Medicine
Male
Medicine
Medicine & Public Health
Middle Aged
Oncology
Original Research
Pharmacology/Toxicology
Rheumatology
Tetrazoles - administration & dosage
Tetrazoles - therapeutic use
Valine - administration & dosage
Valine - analogs & derivatives
Valine - therapeutic use
Valsartan
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Summary:Introduction Patients with stage 2 hypertension require large absolute reductions in blood pressure (BP) to achieve recommended BP goals. Combination therapy with the direct renin inhibitor, aliskiren, and the angiotensin receptor blocker, valsartan, has been shown to produce greater BP reductions than either agent alone in a double-blind study in 1797 hypertensive patients. Methods This post-hoc analysis evaluated the BP-lowering efficacy of aliskiren in combination with valsartan in a subset of patients ( n =581) with stage 2 hypertension (baseline mean sitting systolic BP [msSBP] ≥160 mmHg). Patients were randomized to receive aliskiren/valsartan 150/160 mg, aliskiren 150 mg, valsartan 160 mg, or placebo once daily for 4 weeks followed by 4 weeks at double the initial dose. Mean changes from baseline in msSBP and mean sitting diastolic BP were assessed at week-8 endpoint (intent-to-treat population). Results Aliskiren/valsartan 300/320 mg reduced BP from baseline by 22.5/11.4 mmHg at week-8 endpoint. BP reductions with combination therapy were significantly greater than with aliskiren 300 mg (17.3/8.9 mmHg, P
ISSN:0741-238X
1865-8652
DOI:10.1007/s12325-008-0123-x