PMID- 21680997
OWN - NLM
STAT- MEDLINE
DCOM- 20110824
LR  - 20181201
IS  - 1941-9260 (Electronic)
IS  - 0032-5481 (Linking)
VI  - 123
IP  - 4
DP  - 2011 Jul
TI  - A comparison of the efficacy and safety of irbesartan/hydrochlorothiazide 
      combination therapy with irbesartan monotherapy in the treatment of moderate or 
      severe hypertension in diabetic and obese hypertensive patients: a post-hoc 
      analysis review.
PG  - 126-34
LID - 10.3810/pgm.2011.07.2312 [doi]
AB  - Hypertension is difficult to treat in patients with type 2 diabetes mellitus 
      (T2DM) or obesity. Combination therapies are often required to effectively lower 
      blood pressure (BP) and attain BP goals. In this post-hoc analysis of 2 
      prospective, randomized, controlled studies in patients with uncontrolled or 
      untreated moderate or severe hypertension, the efficacy and safety of treatment 
      with irbesartan/hydrochlorothiazide (HCTZ) and irbesartan was assessed in 2 
      separate analyses: patients with diabetes (n=143) and by obesity status (n=1125). 
      Patients received irbesartan/HCTZ (150 mg/12.5 mg titrated to 300 mg/25 mg) or 
      irbesartan (150 mg titrated to 300 mg) for 7 (severe hypertension study) or 12 
      (moderate hypertension study) weeks. Efficacy comparisons between treatment 
      groups were performed using Fisher's exact tests. After 7 to 8 weeks of 
      treatment, systolic BP (SBP)/diastolic BP (DBP) decreased in patients with 
      diabetes by 26.9/17.8 mm Hg and 21.8/15.8 mm Hg after irbesartan/HCTZ and 
      irbesartan treatment, respectively (P [SBP]=0.09, P [DBP]=0.27). In obese 
      patients (n=544), SBP/DBP decreased by 29.4/20.2 mm Hg and 20.1/15.9 mm Hg after 
      irbesartan/HCTZ and irbesartan treatment, respectively (P<0.0001). More patients 
      with T2DM reached the BP goal of <130/80 mm Hg at week 7 to 8 in the 
      irbesartan/HCTZ group than in the irbesartan group (12% vs 5%), although not 
      statistically significant (P=0.22). Significantly more obese patients reached 
      their respective BP goals in the irbesartan/HCTZ group than in the irbesartan 
      group (48% vs 23%; P<0.0001). Treatment-emergent adverse event rates were similar 
      between treatment groups regardless of the presence of diabetes or body mass 
      index (BMI) status. In patients with moderate or severe hypertension and with a 
      BMI >/= 30 kg/m(2), initial treatment with irbesartan/HCTZ combination therapy was 
      more effective than irbesartan monotherapy.
FAU - Neutel, Joel M
AU  - Neutel JM
AD  - Orange County Research Center, Tustin, CA 92780, USA. jmneutel@aol.com
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Postgrad Med
JT  - Postgraduate medicine
JID - 0401147
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Biphenyl Compounds)
RN  - 0 (Tetrazoles)
RN  - 0J48LPH2TH (Hydrochlorothiazide)
RN  - J0E2756Z7N (Irbesartan)
SB  - IM
MH  - Antihypertensive Agents/administration & dosage/*therapeutic use
MH  - Biphenyl Compounds/administration & dosage/*therapeutic use
MH  - Diabetes Complications/*drug therapy
MH  - Diabetes Mellitus, Type 2/complications
MH  - Double-Blind Method
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Hydrochlorothiazide/administration & dosage/*therapeutic use
MH  - Hypertension/complications/*drug therapy
MH  - Irbesartan
MH  - Male
MH  - Middle Aged
MH  - Obesity/*complications
MH  - Tetrazoles/administration & dosage/*therapeutic use
MH  - Treatment Outcome
EDAT- 2011/06/18 06:00
MHDA- 2011/08/25 06:00
CRDT- 2011/06/18 06:00
PHST- 2011/06/18 06:00 [entrez]
PHST- 2011/06/18 06:00 [pubmed]
PHST- 2011/08/25 06:00 [medline]
AID - 10.3810/pgm.2011.07.2312 [doi]
PST - ppublish
SO  - Postgrad Med. 2011 Jul;123(4):126-34. doi: 10.3810/pgm.2011.07.2312.