COMBINATION OF AMLODIPINE/VALSARTAN/HYDROCHLOROTHIAZIDE AND AMBULATORY BLOOD PRESSURE

Introduction and Objectives: Most moderate-to-severe hypertensive patients require 2 or more agents to achieve the blood pressure (BP) control target. The antihypertensive efficacy of both combinations amlodipine/valsartan (AML/VAL) and valsartan/hydrochlorothiazide (VAL/HCT) has been shown; however, there are vey few data about the triple combination AML/VAL/HCT. The objective of this study has been to evaluate the efficacy of this triple combination on the ambulatory BP. Methods: A retrospective analysis with grade 2–3 hypertensive patients receiving in a sequential way AML 10 mg or VAL 320 mg in monotherapy was made. If the ambulatory BP control target was not achieved (diurnal BP 135/85 mmHg), patients took the combination AML/VAL 10/320 mg daily and, if BP was still high, HCT 25 mg/day was added. The assessment of the antihypertensive efficacy was based on ABPM (Spacelabs 90297) with 3-month intervals. Results: Antihypertensive efficacy was evaluated in 61 patients (54.7 years old) who received the triple combination AML/VAL/HCT. Baseline values of ambulatory SBP/DBP were 159.1/102.5 mmHg in 24 h, 162.3/104.8 mmHg day and 148.4/95.1 mmHg night. After the triple antihypertensive combination, a significant reduction of the ambulatory BP was shown: -32.1/-20.2 mmHg in 24 h BP, -32.8/-20.7 mmHg in diurnal BP and -29.5/18.8 mmHg in nocturnal BP, without changes in the heart rate. The ambulatory BP control target was achieved in more than 80% of patients and a higher incidence of side effects was not shown regarding double therapy AML/VAL. Conclusions: This analysis shows the antihypertensive efficacy and safety of the triple combination AML/VAL/HCT in the treatment of moderate-to-severe hypertensive patients.