Blood Pressure Goal Achievement with Olmesartan Medoxomil-based Treatment: Additional Analysis of the OLMEBEST Study

Overview

Journal Vasc Health Risk Manag

Publisher Dove Medical Press

Specialty Cardiology & Vascular Diseases

Date 2009 Sep 17

PMID 19756164

Authors

Vivencio Barrios

Carlos Escobar

Alberto Calderon

Michael Bohm

Affiliations

Soon will be listed here.

Abstract

Aims: Guidelines recommend blood pressure (BP) in hypertensive patients should be <140 systolic BP (SBP) and <90 diastolic BP (DBP) mmHg. This analysis assessed goal rate achievement in hypertensive patients receiving olmesartan-based treatment in the OLMEBEST study.

Methods: Patients with essential hypertension (DBP > or = 90 mmHg and <110 mmHg) received open-label olmesartan medoxomil 20 mg/day (n = 2306). After 8 weeks, patients with DBP > or = 90 mmHg (n = 627) were randomized to 4 weeks' double-blind treatment with olmesartan 40 mg/day monotherapy or olmesartan 20 mg/day plus hydrochlorothiazide (HCTZ) 12.5 mg/day. For this analysis, the numbers and proportions of patients who achieved SBP < 140 mmHg and/or DBP < 90 mmHg at the end of the 4 weeks were calculated.

Results: In patients who achieved DBP normalization (<90 mmHg) at week 8 (n = 1546) and continued open-label olmesartan 20 mg/day, 66.7% achieved SBP/DBP < 140/90 mmHg at Week 12. In patients who did not achieve DBP normalization at Week 8, 26.8% of those randomized to olmesartan 40 mg/day and 42.5% of those randomized to olmesartan 20 mg/day plus HCTZ 12.5 mg/day achieved a SBP/DBP < 140/90 mmHg at Week 12.

Conclusion: Olmesartan 40 mg/day and olmesartan 20 mg/day plus HCTZ 12.5 mg/day allow substantial proportions of patients to achieve BP goals.

References

Neutel J, Smith D, Weber M, Wang A, Masonson H . Use of an olmesartan medoxomil-based treatment algorithm for hypertension control. J Clin Hypertens (Greenwich). 2004; 6(4):168-74. PMC: 8109519. DOI: 10.1111/j.1524-6175.2006.03304.x. View

Weir M, Crikelair N, Levy D, Rocha R, Kuturu V, Glazer R . Evaluation of the dose response with valsartan and valsartan/hydrochlorothiazide in patients with essential hypertension. J Clin Hypertens (Greenwich). 2007; 9(2):103-12. PMC: 8110071. DOI: 10.1111/j.1524-6175.2007.06415.x. View

Neutel J . Clinical studies of CS-866, the newest angiotensin II receptor antagonist. Am J Cardiol. 2001; 87(8A):37C-43C. DOI: 10.1016/s0002-9149(01)01510-7. View

Barrios V, Escobar C . Olmesartan medoxomil plus hydrochlorothiazide for treating hypertension. Expert Opin Pharmacother. 2007; 9(1):129-36. DOI: 10.1517/14656566.9.1.129. View

Giles T, Oparil S, Silfani T, Wang A, Walker J . Comparison of increasing doses of olmesartan medoxomil, losartan potassium, and valsartan in patients with essential hypertension. J Clin Hypertens (Greenwich). 2007; 9(3):187-95. PMC: 8110085. DOI: 10.1111/j.1524-6175.2007.06395.x. View

Chrysant S, Weber M, Wang A, Hinman D . Evaluation of antihypertensive therapy with the combination of olmesartan medoxomil and hydrochlorothiazide. Am J Hypertens. 2004; 17(3):252-9. DOI: 10.1016/j.amjhyper.2003.11.003. View

Brunner H, Arakawa K . Antihypertensive efficacy of olmesartan medoxomil and candesartan cilexetil in achieving 24-hour blood pressure reductions and ambulatory blood pressure goals. Clin Drug Investig. 2006; 26(4):185-93. DOI: 10.2165/00044011-200626040-00002. View

Kjeldsen S, Os I, Hoieggen A, Beckey K, Gleim G, Oparil S . Fixed-dose combinations in the management of hypertension: defining the place of angiotensin receptor antagonists and hydrochlorothiazide. Am J Cardiovasc Drugs. 2005; 5(1):17-22. DOI: 10.2165/00129784-200505010-00003. View

Wolf-Maier K, Cooper R, Kramer H, Banegas J, Giampaoli S, Joffres M . Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension. 2003; 43(1):10-7. DOI: 10.1161/01.HYP.0000103630.72812.10. View

10.

Barrios V, Boccanelli A, Ewald S, Girerd X, Heagerty A, Krzesinski J . Efficacy and tolerability of olmesartan medoxomil in patients with mild to moderate essential hypertension: the OLMEBEST Study. Clin Drug Investig. 2007; 27(8):545-58. DOI: 10.2165/00044011-200727080-00003. View

11.

Birkenhager W, de Leeuw P . Non-peptide angiotensin type 1 receptor antagonists in the treatment of hypertension. J Hypertens. 1999; 17(7):873-81. DOI: 10.1097/00004872-199917070-00002. View

12.

Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G . 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007; 25(6):1105-87. DOI: 10.1097/HJH.0b013e3281fc975a. View

13.

Brunner H, Laeis P . Clinical efficacy of olmesartan medoxomil. J Hypertens Suppl. 2003; 21(2):S43-6. DOI: 10.1097/00004872-200305002-00008. View

14.

Kannel W . Blood pressure as a cardiovascular risk factor: prevention and treatment. JAMA. 1996; 275(20):1571-6. View

15.

Barrios V, Escobar C, Calderon A, Llisterri J, Echarri R, Alegria E . Blood pressure and lipid goal attainment in the hypertensive population in the primary care setting in Spain. J Clin Hypertens (Greenwich). 2007; 9(5):324-9. PMC: 8109970. DOI: 10.1111/j.1524-6175.2007.06481.x. View

16.

Wagstaff A . Valsartan/hydrochlorothiazide: a review of its use in the management of hypertension. Drugs. 2006; 66(14):1881-901. DOI: 10.2165/00003495-200666140-00011. View

17.

Rump L, Ambrosioni E, Burnier M, Horl W, Rabelink A . Initial combination therapy with olmesartan/hydrochlorothiazide in moderate-to-severe hypertension. J Hum Hypertens. 2006; 20(4):299-301. DOI: 10.1038/sj.jhh.1001984. View

18.

Puchler K, Laeis P, Stumpe K . Blood pressure response, but not adverse event incidence, correlates with dose of angiotensin II antagonist. J Hypertens Suppl. 2001; 19(1):S41-8. DOI: 10.1097/00004872-200106001-00006. View

19.

Oparil S, Williams D, Chrysant S, Marbury T, Neutel J . Comparative efficacy of olmesartan, losartan, valsartan, and irbesartan in the control of essential hypertension. J Clin Hypertens (Greenwich). 2001; 3(5):283-91, 318. PMC: 8101821. DOI: 10.1111/j.1524-6175.2001.01136.x. View

20.

Ball K, Williams P, Stumpe K . Relative efficacy of an angiotensin II antagonist compared with other antihypertensive agents. Olmesartan medoxomil versus antihypertensives. J Hypertens Suppl. 2001; 19(1):S49-56. DOI: 10.1097/00004872-200106001-00007. View