PMID- 19254206
OWN - NLM
STAT- MEDLINE
DCOM- 20090810
LR  - 20221207
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 25
IP  - 4
DP  - 2009 Apr
TI  - Efficacy and safety of losartan 100 mg or losartan 100 mg plus 
      hydrochlorothiazide 25 mg in the treatment of patients with essential arterial 
      hypertension and CV risk factors: observational, prospective study in primary 
      care.
PG  - 981-90
LID - 10.1185/03007990902809876 [doi]
AB  - BACKGROUND: Patients with high cardiovascular risk are prevalent in ambulatory 
      care. To achieve adequate blood pressure control, such patients require higher 
      drug doses and/or combination therapy. We aimed to assess the efficacy and safety 
      of losartan 100 mg as monotherapy or in fixed-dose combination with 
      hydrochlorothiazide 25 mg. DESIGN AND METHODS: Multicentre, prospective, open 
      observational study over 13 weeks in patients with essential hypertension, whose 
      blood pressure was not adequately controlled despite pretreatment. Main outcome 
      parameters were the systolic (SBP) and diastolic (DBP) blood pressure reduction, 
      the rate of normalized patients at study end compared to baseline, and the number 
      and type of adverse events (AEs). RESULTS: Of the 7702 documented patients, 53.1% 
      (N = 4088) were men, with a mean age of 63.5 +/- 10.7 years. Comorbidities were 
      frequent (diabetes mellitus in 57.4% [N = 4418], coronary heart disease in 30.3% 
      [N = 2330], left ventricular hypertrophy in 28.2% [N = 2172], heart failure in 
      14.0% [N = 1079], and peripheral arterial disease in 9.0% [N = 690]). Patients 
      received losartan 100 mg in 45.7% (N = 3521), losartan/HCTZ in 53.8% (N = 4143); 
      additional antihypertensive drugs were given in 45.5% (N = 3505). Physicians 
      reported somewhat lower target values than those stipulated by the guidelines 
      (irrespective of age, gender, and concomitant diseases except for diabetes). Mean 
      SBP/DBP decreased from a baseline value of 158/93 mmHg by 24/12 mmHg at study 
      end. The BP lowering effect was similar in subgroups by treatment or comorbidity, 
      respectively, however target attainment rates were substantially higher in 
      non-diabetic patients. Metabolic and renal parameters (fasting glucose, HbA(1c), 
      serum creatinine and albumin in urine) showed trends for improvement. 
      Tolerability was very good, as only 0.43% (N = 33) experienced an AE (in 0.31% [N 
      = 24] serious AEs), and 0.08% (N = 6) discontinued therapy due to reasons related 
      to study drug. CONCLUSION: In high-risk patients, treatment with losartan 100 mg 
      or losartan/HCTZ 100/25 mg was effective and well tolerated, irrespective of 
      comorbidity. These findings from a real-life setting are in line with those from 
      randomized controlled trials.
FAU - Bonner, G
AU  - Bonner G
AD  - Median Kliniken Bad Krozingen, Herbert-Hellmann-Allee 44, Bad Krozingen, Germany. 
      gerd.bonner@dgn.de
FAU - Smolka, W
AU  - Smolka W
FAU - Jung, C
AU  - Jung C
FAU - Bestehorn, K
AU  - Bestehorn K
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0J48LPH2TH (Hydrochlorothiazide)
RN  - AYI8EX34EU (Creatinine)
RN  - JMS50MPO89 (Losartan)
SB  - IM
MH  - Aged
MH  - Antihypertensive Agents/therapeutic use
MH  - Blood Pressure/*drug effects
MH  - Creatinine/blood
MH  - Diabetes Complications/epidemiology
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Hydrochlorothiazide/*therapeutic use
MH  - Hypertension/*drug therapy/physiopathology
MH  - Losartan/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Safety
EDAT- 2009/03/04 09:00
MHDA- 2009/08/11 09:00
CRDT- 2009/03/04 09:00
PHST- 2009/03/04 09:00 [entrez]
PHST- 2009/03/04 09:00 [pubmed]
PHST- 2009/08/11 09:00 [medline]
AID - 10.1185/03007990902809876 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2009 Apr;25(4):981-90. doi: 10.1185/03007990902809876.