title: Titration of HCTZ to 50 mg daily in individuals with stage 2 systolic hypertension pretreated with an angiotensin receptor blocker.
abstract: The authors studied the combination of hydrochlorothiazide (HCTZ) 50 mg/d plus olmesartan medoxomil (OM) 40 mg/d in stage 2 systolic hypertension during an extension phase of an open-label 12-week dose titration study. Subjects whose blood pressure remained above 120/80 mm Hg (n=105) on OM 40/HCTZ 25 mg/d subsequently received OM 40/HCTZ 50 mg/d for 4 weeks. Increasing HCTZ from 25 mg/d to 50 mg/d decreased systolic blood pressure by 3.6 mm Hg, increased BP control rates (<140/90 mm Hg) from 70.4% to 77.5%, and increased BP normalization rates (<120/80 mm Hg) from 15.4% to 27.8%. The combination was well tolerated. Compared with OM 40 mg/d monotherapy, neither dose of HCTZ affected serum potassium, but both increased serum glucose by about 5%. There was a dose-dependent increase in uric acid but no acute gout attacks. OM 40/HCTZ 50 mg/d is an effective strategy for managing stage 2 systolic hypertension.
authors.affiliation: Department of Medicine, State University of New York at Buffalo, Buffalo, NY 14215, USA. jizzo@ams.ecmc.edu
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Izzo
authors.forename: Joel M
authors.initials: JM
authors.lastname: Neutel
authors.forename: Tonous
authors.initials: T
authors.lastname: Silfani
authors.forename: Robert
authors.initials: R
authors.lastname: Dubiel
authors.forename: Findlay
authors.initials: F
authors.lastname: Walker
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D004232:Diuretics / Q000008:administration & dosage* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage* / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007093:Imidazoles / Q000008:administration & dosage* / Q000627:therapeutic use; D000068557:Olmesartan Medoxomil; D013777:Tetrazoles / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D004232:Diuretics; D007093:Imidazoles; D013777:Tetrazoles; D006852:Hydrochlorothiazide; D000068557:Olmesartan Medoxomil