Reaching the therapeutic goal in hypertension: results from the Canadian valsartan observational study. (Diovantage 4).
BACKGROUND
Hypertension is a leading cause of death worldwide, and a major public health problem in Canada. Despite treatment guidelines and availability of therapies for blood pressure (BP) management, treatment of hypertension remains sub-optimal.


OBJECTIVE
The objectives of this trial are to observe BP reduction, compliance and regimen changes 3 months after initiation of valsartan alone or with hydrochlorothiazide and optimized patient support.


METHODS
As of February 2007, 34,033 patients with essential hypertension and prescribed valsartan alone or with hydrochlorothiazide for BP management were enrolled across 2,125 Canadian sites. Patients were newly diagnosed (38%), switched from another anti-hypertensive agent (38%) or received valsartan with or without hydrochlorothiazide as added therapy (20%). All patients were offered a home blood pressure monitor, access to nursing support and educational materials. Patients were assessed after 3 months for compliance, therapeutic response, and need for treatment modifications.


RESULTS
In this interim analysis, after 3 months of treatment, 95% of patients reported being compliant with therapy and 59% achieved target BP (<140/90 mmHg). In the evaluable population (n=15,200), significant reductions in mean systolic (-18.5+/-19.3 mm/Hg, p<0.0001) and diastolic (-9.4+/-11.2 mmHg; p<0.0001) BP were observed. For patients not reaching target BP goals, no change in treatment was instituted in 55% of cases.


CONCLUSIONS
This observational study demonstrates the benefits of valsartan alone or with hydrochlorothiazide and optimized patient support in BP management of patients with essential hypertension. Interestingly, no modification to the anti-hypertensive regimen was done in 55% of patients not having reached treatment goals.
Department of Medicine and Research Center, Montreal Heart Institute and Université de Montréal, Montreal, Quebec, Canada. jean-claude.tardif@icm-mhi.org
Jean-Claude
JC
Tardif
Gregory P
GP
Curnew
Jean-Marie
JM
Leclerc
Bonita
B
Rehel
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002170:Canada; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D013777:Tetrazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
D000959:Antihypertensive Agents; D013777:Tetrazoles; D006852:Hydrochlorothiazide; D000068756:Valsartan; D014633:Valine