For uncontrolled patients on monotherapy who later switched to a fixed combination dose of amlodupine and olmesartan medoxomil (AML/OM), 75.8 percent of hypertensive patients achieved systolic blood pressure (BP) goals of less than 140 mm Hg, according to a poster presentation at the American Society of Hypertension (ASH) May 1-4 in New York City.
According to the preliminary results presented by Joel Neutel, MD, of the Orange County Heart Institute and Research Center in Tustin, Calif., “Although more patients are receiving anti-hypertensive therapy, the most recent National Health and Nutrition Examination Surveys (NHANES) data suggest that blood pressure remains uncontrolled in approximately one-third of treated patients.”
"Non-adherence to therapy and/or clinical inertia, which occurs when practitioners fail to increase dosages or add new medications when treatment goals remain unmet, are both contributing factors in preventing adequate BP control," the authors wrote.
During the BP CRUSH ( Blood Pressure Control in All S ubgroups with Hypertension) study, 736 hypertensive patients who were non-responders to anti-hypertensive monotherapy at 145 sites were selected to participate in the 20-week trial.
All patients were aged 18 to 80, had uncontrolled hypertension defined as systolic BP equal to or greater than 140 mm Hg and equal or less than 180 mm Hg with diastolic BP equal to or less than 110 mm Hg.
The researchers evaluated primary endpoints including the number of patients who achieved cumulative seated systolic BP (SeSBP) goals of less than 140 mm Hg or 130 mm Hg (diabetics or those with chronic kidney disease) 12 weeks after active treatment.
On day one of the trial, patients were switched over to a 5/20 mg of AML/OM.
Of the total patient cohort, 75.8 percent achieved the BP goal of less than 140 mm Hg during the first 12 weeks. For diabetics, this rate was 57.9 percent, 80.1 percent for non-diabetics.
Additionally, 84.3 percent of patients had BP levels that reached below 90 mm Hg during the first 12 weeks and cumulative SeSBP goals of 140/90 mm Hg were achieved by 90.3 percent of the patients who were put on the AML/OM-based titration regimen.
“The combination of AML/OM, with or without HCTZ [hydrochlorothiazide], was well tolerated with the majority of adverse events being of mild-to-moderate severity,” the authors concluded.