Document Detail


Initial combination therapy compared with monotherapy in diabetic hypertensive patients.
MedLine Citation:
PMID:  18844761     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Subgroup analyses were performed for the diabetic and nondiabetic cohorts from 3 randomized clinical trials that had evaluated the systolic blood pressure (SBP)-lowering efficacy and tolerability of an angiotensin receptor blocker, valsartan, alone or in combination with hydrochlorothiazide to determine when and how to initiate combination therapy in hypertensive patients with diabetes. Blood pressure reductions achieved with monotherapy were compared with combination therapy in the diabetic and nondiabetic cohorts. In addition, multivariate models were developed to predict the likelihood of the goal SBP of < 130 mm Hg being reached in a diabetic patient with monotherapy or combination therapy across the range of baseline SBP values. In 2 of the 3 trials, comparable reductions in SBP were seen in the diabetic and nondiabetic cohorts. In all 3 studies, however, combination therapy provided greater blood pressure-lowering efficacy than monotherapy. The probability of achieving goal SBP was greater for diabetic patients started on combination therapy compared with monotherapy.
Authors:
James R Sowers; Guido Lastra; Ricardo Rocha; Yodit Seifu; Nora Crikelair; Drew G Levy
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  10     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-10-10     Completed Date:  2009-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  668-76     Citation Subset:  IM    
Affiliation:
Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, MO, USA. sowersj@health.missouri.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Antihypertensive Agents / administration & dosage,  therapeutic use*
Blood Glucose / metabolism
Blood Pressure / physiology
C-Reactive Protein / metabolism
Diabetes Mellitus, Type 1 / blood,  complications*,  drug therapy
Diabetes Mellitus, Type 2 / blood,  complications*,  drug therapy
Diuretics / administration & dosage,  therapeutic use*
Dose-Response Relationship, Drug
Double-Blind Method
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Hydrochlorothiazide / administration & dosage,  therapeutic use*
Hypertension / complications,  drug therapy*,  physiopathology
Hypoglycemic Agents / therapeutic use
Male
Middle Aged
Severity of Illness Index
Tetrazoles / administration & dosage,  therapeutic use*
Treatment Outcome
Valine / administration & dosage,  analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Blood Glucose; 0/Diuretics; 0/Hypoglycemic Agents; 0/Tetrazoles; 137862-53-4/valsartan; 58-93-5/Hydrochlorothiazide; 7004-03-7/Valine; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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