Once-daily fixed-combination irbesartan 300 mg/ hydrochlorothiazide 25 mg and circadian blood pressure profile in patients with essential hypertension

Coca, António; Calvo, Carlos; Sobrino, Javier; López-Paz, JoséE.; Sierra, Cristina; Gómez, Ernesto Sánchez; Bragulat, Ernesto; Sierra, Alejandro de la

doi:10.1016/s0149-2918(03)80338-7

Cited by 28 publications

(28 citation statements)

References 38 publications

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“…There are also arguments relevant to the proper timing of instituting a chosen fixed combination-that is, as first choice upon initiation of drug therapy or upon reaching the BP goal, after which no further changes are likely to be needed [31][32][33][34][35]. Table 1 summarizes the pros and cons of these choices.…”

Section: Fixed Drug Combinationsmentioning

confidence: 99%

Combination therapy as first-line treatment for hypertension

Gavras

Rosenthal

2004

Current Science Inc

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With the cut-off point between "normal" and "high" blood pressure (BP) being pushed increasingly downward, especially for patients with multiple cardiovascular risk factors, most hypertensives need more than one antihypertensive agent to reach their target BP. In this article, we examine the rationale for combining drugs from different classes that have synergistic or additive effects and properties that might offset one another's adverse hemodynamic and/or metabolic reactions. We suggest circumstances in which the initiation of therapy with a fixed two-drug combination might be preferable to the usual practice of starting with monotherapy followed by upward titration and addition of other agents, and we briefly review the existing fixed drug combinations. We end with the intriguing and provocative notion of the future "polypill," a fixed combination of agents addressing various components of the metabolic syndrome as well as other coexisting common risk factors in both high-risk patients with conditions requiring polypharmacy and in healthy, asymptomatic individuals.

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Section: Fixed Drug Combinationsmentioning

confidence: 99%

Combination therapy as first-line treatment for hypertension

Gavras

Rosenthal

2004

Current Science Inc

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“…Target BP levels were achieved in 77% (95% CI, 74-80%) of the patients for systolic (<140 mmHg; <130 mmHg for patients with type 2 diabetes mellitus), 83% (95% CI, 80-86%) for diastolic (<90 mmHg; <80 mmHg for patients with type 2 diabetes mellitus) and 69% (95% CI, 66-72%) for both BP levels. Sixtynine percent of patients enrolled in this study reached both systolic and diastolic BP goals with irbesartan/HCTZ combination therapy and this shows that such a combination therapy may be a convenient treatment option in patients with uncontrolled BP levels with monotherapy and also simplify the treatment [70].…”

Section: Blood Pressure Lowering Efficacy Of Irbesartan Alone and Itsmentioning

confidence: 66%

“…. A high fixed-dose combination of irbesartan 300 mg/HCTZ 25 mg given once daily was also effective and well tolerated in patients with previously uncontrolled hypertension [70]. As well as significantly reducing both clinic and ambulatory BP, 12 weeks of treatment preserved the circadian profile as shown by trough-to-peak ratios and smoothness index values for both systolic BP and diastolic BP.…”

Section: Pharmacodynamicsmentioning

confidence: 95%

“…Further subanalyses showed that 96% of elderly patients achieved diastolic BP control and 73% achieved systolic BP. Over 70% of the elderly people, African-Americans, Hispanic/Latinos, those with MS, women and men achieved both systolic and diastolic BP control [70]. Combination therapy was well tolerated and the results consistent across diverse patient populations [11].…”

Section: Pharmacodynamicsmentioning

confidence: 99%

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Irbesartan and Hydrochlorothiazide Association in the Treatment of Hypertension

Derosa¹,

Ferrari²,

Cicero³

2009

CVP

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Blood pressure (BP) is one of the most important and common vascular risk factors but it is often poorly controlled. Inhibition of the renin-angiotensin-aldosterone system (RAAS) provides beneficial effects in hypertensives. The association of low-dosed diuretics in combination with RAAS blocking agents allows maximum benefit from potassium depletion and control of compensatory increase in renin secretion, so increasing the efficacy and safety of RAAS blockers. Irbesartan is a potent and selective angiotensin II subtype 1 receptor antagonist indicated for use in patients with hypertension, including those with type 2 diabetes mellitus and nephropathy. Once-daily irbesartan administration provides 24h control of BP. In patients with mild-to-moderate hypertension, irbesartan was as effective as enalapril, atenolol and amlodipine, and more effective than losartan and valsartan in terms of absolute reduction in BP and response rate. Irbesartan also induced regression of left ventricular hypertrophy. Moreover, irbesartan 300 mg/day exerts a significant renoprotective effect in hypertensive type 2 diabetic patients. The relative risk of doubling of serum creatinine was significantly lower with irbesartan than amlodipine or placebo. Irbesartan was also effective in non-diabetic nephropatic patients. Moreover, irbesartan has peroxisome proliferator-activated receptor agonistic effects in in vitro studies, and it also demonstrated beneficial effects on inflammatory markers of atherosclerosis and endothelial function. The overall incidence of adverse events is similar to that of placebo. A fixed dose of hydrochlorothiazide (HCTZ) and irbesartan shows additive antihypertensive effect in a dose dependent manner up to HCTZ 25 mg and irbesartan 300 mg with high tolerability in diverse patient groups. Combination effects on end organ protection must be evaluated by broad spectrum studies. Ongoing trials about irbesartan and its combination with diuretics may provide necessary data to interpret the value of this association among others.

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“…These results strongly suggest that the combination therapy affected whole kidney and glomerular hemodynamics to an extent that was sufficient to normalize the pressure load in the glomerulus, leading to improved GHF and a decrease in glomerular injury [24]. The clinical advantage of this combination therapy providing glomerular protection by decreasing the GFR has not been demonstrated clearly, although a series of large-scale clinical trials showed that the blood pressure-lowering effect of combination therapy was potentially greater than that of ARB monotherapy [25,26,27,28]. …”

Section: Discussionmentioning

confidence: 99%

Release From Glomerular Overload by the Addition of Low-dose Thiazide in Patients With Angiotensin Receptor Blocker-Resistant Hypertension

Hasegawa

Tayama

Takayanagi

et al. 2013

Kidney Blood Press Res

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Background/Aims: This multicenter, prospective, observational study assessed the renoprotective effects of losartan/thiazide combination therapy in terms of lowering the estimated glomerular filtration rate (eGFR). Methods: Adult patients with angiotensin receptor blocker (ARB)-resistant essential hypertension (n = 104) were enrolled and switched to combination therapy with losartan (50 mg/day) and hydrochlorothiazide (12.5 mg/day). Results: eGFR values declined significantly during the first 3 months, and changes in eGFR were assessed according to tertiles of the eGFR decrease ratio at 3 months. Only the high eGFR decrease (1st tertile) group showed significantly greater decreases in baseline eGFR and albumin-to-creatinine ratio (ACR) during the first 3 months. Additionally, the assessment according to tertiles of the baseline eGFR showed a signifcant decrease in eGFR and ACR during the first 3 months in the high baseline eGFR (1st tertile) group, but not in the moderate (2nd tertile) and low baseline eGFR (3rd tertile) groups. Conclusion: The present results revealed that losartan/thiazide combination therapy attenuated glomerular overload, indicating that this therapy may provide glomerular protection in patients with an elevated GFR without causing prolonged damage to renal function.

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Once-daily fixed-combination irbesartan 300 mg/ hydrochlorothiazide 25 mg and circadian blood pressure profile in patients with essential hypertension

Cited by 28 publications

References 38 publications

Combination therapy as first-line treatment for hypertension

Combination therapy as first-line treatment for hypertension

Irbesartan and Hydrochlorothiazide Association in the Treatment of Hypertension

Release From Glomerular Overload by the Addition of Low-dose Thiazide in Patients With Angiotensin Receptor Blocker-Resistant Hypertension

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