Treating systolic hypertension in the very elderly with valsartan-hydrochlorothiazide vs either monotherapy: ValVET primary results

Joseph L. Izzo; Howard S. Weintraub; Daniel A. Duprez; Das Purkayastha; Dion Zappe; Rita Samuel; William C. Cushman

doi:10.1111/j.1751-7176.2011.00498.x

Treating systolic hypertension in the very elderly with valsartan-hydrochlorothiazide vs either monotherapy: ValVET primary results

Joseph L. Izzo
, Howard S. Weintraub
, Daniel A. Duprez
, Das Purkayastha
, Dion Zappe
, Rita Samuel
, William C. Cushman

Medicine

New York University
University of Minnesota Twin Cities
Novartis
University of Tennessee Health Science Center

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

This 16-week trial investigated the efficacy and safety of single-pill valsartan/hydrochlorothiazide (HCTZ) vs the individual components in patients 70years and older with systolic hypertension. Patients were randomized to valsartan/HCTZ 160/12.5mg (n=128), HCTZ 12.5mg (n=128), or valsartan 160mg (n=128) for 4weeks. Patients whose blood pressure (BP) was ≥140/90mmHg at weeks 4, 8, or 12 were up-titrated to a maximum of valsartan/HCTZ 320/25mg. Week 4 systolic BP reduction (primary efficacy outcome) was greater with valsartan/HCTZ than valsartan (-17.3mmHg vs -8.6mmHg, P<.0001) but only marginally greater than HCTZ (-13.6mmHg, P = .096). Median time to BP control was shorter with valsartan/HCTZ (4weeks) vs HCTZ (8weeks, P<.05) or valsartan (12weeks, P<.0001). Thiazide monotherapy was more effective than angiotensin receptor blocker monotherapy (by about 5mmHg), but greater antihypertensive efficacy was achieved by initiating treatment with combination valsartan/HCTZ in the elderly.

Original language	English
Pages (from-to)	722-730
Number of pages	9
Journal	Journal of Clinical Hypertension
Volume	13
Issue number	10
DOIs	https://doi.org/10.1111/j.1751-7176.2011.00498.x
State	Published - Oct 2011

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title = "Treating systolic hypertension in the very elderly with valsartan-hydrochlorothiazide vs either monotherapy: ValVET primary results",

abstract = "This 16-week trial investigated the efficacy and safety of single-pill valsartan/hydrochlorothiazide (HCTZ) vs the individual components in patients 70years and older with systolic hypertension. Patients were randomized to valsartan/HCTZ 160/12.5mg (n=128), HCTZ 12.5mg (n=128), or valsartan 160mg (n=128) for 4weeks. Patients whose blood pressure (BP) was ≥140/90mmHg at weeks 4, 8, or 12 were up-titrated to a maximum of valsartan/HCTZ 320/25mg. Week 4 systolic BP reduction (primary efficacy outcome) was greater with valsartan/HCTZ than valsartan (-17.3mmHg vs -8.6mmHg, P<.0001) but only marginally greater than HCTZ (-13.6mmHg, P = .096). Median time to BP control was shorter with valsartan/HCTZ (4weeks) vs HCTZ (8weeks, P<.05) or valsartan (12weeks, P<.0001). Thiazide monotherapy was more effective than angiotensin receptor blocker monotherapy (by about 5mmHg), but greater antihypertensive efficacy was achieved by initiating treatment with combination valsartan/HCTZ in the elderly.",

author = "Izzo, \{Joseph L.\} and Weintraub, \{Howard S.\} and Duprez, \{Daniel A.\} and Das Purkayastha and Dion Zappe and Rita Samuel and Cushman, \{William C.\}",

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doi = "10.1111/j.1751-7176.2011.00498.x",

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AU - Izzo, Joseph L.

AU - Weintraub, Howard S.

AU - Duprez, Daniel A.

AU - Purkayastha, Das

AU - Zappe, Dion

AU - Samuel, Rita

AU - Cushman, William C.

PY - 2011/10

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N2 - This 16-week trial investigated the efficacy and safety of single-pill valsartan/hydrochlorothiazide (HCTZ) vs the individual components in patients 70years and older with systolic hypertension. Patients were randomized to valsartan/HCTZ 160/12.5mg (n=128), HCTZ 12.5mg (n=128), or valsartan 160mg (n=128) for 4weeks. Patients whose blood pressure (BP) was ≥140/90mmHg at weeks 4, 8, or 12 were up-titrated to a maximum of valsartan/HCTZ 320/25mg. Week 4 systolic BP reduction (primary efficacy outcome) was greater with valsartan/HCTZ than valsartan (-17.3mmHg vs -8.6mmHg, P<.0001) but only marginally greater than HCTZ (-13.6mmHg, P = .096). Median time to BP control was shorter with valsartan/HCTZ (4weeks) vs HCTZ (8weeks, P<.05) or valsartan (12weeks, P<.0001). Thiazide monotherapy was more effective than angiotensin receptor blocker monotherapy (by about 5mmHg), but greater antihypertensive efficacy was achieved by initiating treatment with combination valsartan/HCTZ in the elderly.

AB - This 16-week trial investigated the efficacy and safety of single-pill valsartan/hydrochlorothiazide (HCTZ) vs the individual components in patients 70years and older with systolic hypertension. Patients were randomized to valsartan/HCTZ 160/12.5mg (n=128), HCTZ 12.5mg (n=128), or valsartan 160mg (n=128) for 4weeks. Patients whose blood pressure (BP) was ≥140/90mmHg at weeks 4, 8, or 12 were up-titrated to a maximum of valsartan/HCTZ 320/25mg. Week 4 systolic BP reduction (primary efficacy outcome) was greater with valsartan/HCTZ than valsartan (-17.3mmHg vs -8.6mmHg, P<.0001) but only marginally greater than HCTZ (-13.6mmHg, P = .096). Median time to BP control was shorter with valsartan/HCTZ (4weeks) vs HCTZ (8weeks, P<.05) or valsartan (12weeks, P<.0001). Thiazide monotherapy was more effective than angiotensin receptor blocker monotherapy (by about 5mmHg), but greater antihypertensive efficacy was achieved by initiating treatment with combination valsartan/HCTZ in the elderly.

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ER -

Treating systolic hypertension in the very elderly with valsartan-hydrochlorothiazide vs either monotherapy: ValVET primary results

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