title: Blood pressure-lowering effects of angiotensin receptor antagonist monotherapy and in combination with other anti-hypertensive drugs in primary care settings in Japan.
abstract: Combination therapy with multiple anti-hypertensives is required to achieve target blood pressure (BP) control and is recommended as the first-line therapy in hypertension. Although angiotensin receptor blockers (ARBs) may be combined with other anti-hypertensives, it is unclear how the effects of ARBs are influenced by co-administered anti-hypertensives. We investigated the effect of olmesartan medoxomil (OLM) when it is given alone (monotherapy) or concomitantly with other anti-hypertensives in 6507 OLM-naive Japanese in "real world" clinical practice. After a 12-week treatment, BP was significantly reduced from baseline in both the monotherapy group and the combination therapy group (P < 0.0001). The BP-lowering efficacy after treatment and achievement rates of target BP were similar in both groups. In the combination therapy group, no significant difference of achieved BP level was detected between patients taking Calcium channel blockers and any other class of anti-hypertensive drugs. This study suggests that ARBs such as OLM-elicits BP-lowering efficacy as either a first- or second-line agent and its effects are minimally influenced by co-administered anti-hypertensives.
authors.affiliation: Nihon University Health Planning Center, Chiyoda-ku, Tokyo, Japan. kushiro@med.nihon-u.ac.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Kushiro
authors.forename: Ikuo
authors.initials: I
authors.lastname: Saito
authors.forename: Koji
authors.initials: K
authors.lastname: Hirata
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Tomonari
authors.initials: T
authors.lastname: Yamashita
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Matsushita
authors.forename: Kei
authors.initials: K
authors.lastname: Sagawa
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Hiramatsu
authors.forename: Masahiro
authors.initials: M
authors.lastname: Komiya