Targeting hypertension with valsartan: Lessons learned from the Valsartan/HCTZ versus Amlodipine in stage II hypertensive patients (VASt) trial.
Many patients with hypertension, especially those at increased risk because of additional cardiovascular risk factors, require treatment with more than one antihypertensive agent to achieve target blood pressure (BP) goals. Many different classes of antihypertensive agents are available: a renin-angiotensin-aldosterone system (RAAS) blocker and a diuretic are widely used in combination. Here we report the results of the recently completed Valsartan/HCTZ versus Amlodipine in STage II hypertensive patients (VAST) trial. In this 24-week study, patients with moderate hypertension and at least one other cardiovascular risk factor were treated with a combination of valsartan 160 mg and hydrochlorothiazide (HCTZ) 12.5 or 25 mg once daily (o.d.), or with amlodipine monotherapy (10 mg o.d.). Overall, valsartan plus HCTZ 25 mg reduced systolic BP significantly more than amlodipine monotherapy, and with fewer adverse events. In addition, combination therapy resulted in a trend towards more favourable outcomes with respect to pro-thrombotic and proinflammatory markers than amlodipine alone.
Ruilope
Luis M
LM
Internal Medicine, Comlutense University, Madrid, Spain. ruilope@ad-hocbox.com
Zanchetti
Alberto
A
D017311:Amlodipine / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D004338:Drug Combinations; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006973:Hypertension / Q000188:drug therapy*; D015850:Interleukin-6 / Q000378:metabolism; D008077:Lipoproteins, LDL / Q000378:metabolism; D013777:Tetrazoles / Q000627:therapeutic use*; D010959:Tissue Plasminogen Activator / Q000378:metabolism; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
D004338:Drug Combinations; D015850:Interleukin-6; D008077:Lipoproteins, LDL; D013777:Tetrazoles; C099252:oxidized low density lipoprotein; D006852:Hydrochlorothiazide; D017311:Amlodipine; D000068756:Valsartan; D002097:C-Reactive Protein; D010959:Tissue Plasminogen Activator; D014633:Valine