Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients
Morning hypertension is an independent risk for cerebrovascular and cardiovascular events. Although the prevalence of morning hypertension increases with age, treatment of morning hypertension has not been established, particularly in Very-Elderly patients. We compared the safety and efficacy of a l...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2018-04-01
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| Series: | Clinical and Experimental Hypertension |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/10641963.2017.1368536 |
| _version_ | 1797681406038507520 |
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| author | Hiroki Uchiwa Hisashi Kai Yoshiko Iwamoto Takahiro Anegawa Hidemi Kajimoto Kenji Fukuda Tsutomu Imaizumi Yoshihiro Fukumoto for the MAPPY Study Investigators |
| author_facet | Hiroki Uchiwa Hisashi Kai Yoshiko Iwamoto Takahiro Anegawa Hidemi Kajimoto Kenji Fukuda Tsutomu Imaizumi Yoshihiro Fukumoto for the MAPPY Study Investigators |
| author_sort | Hiroki Uchiwa |
| collection | DOAJ |
| description | Morning hypertension is an independent risk for cerebrovascular and cardiovascular events. Although the prevalence of morning hypertension increases with age, treatment of morning hypertension has not been established, particularly in Very-Elderly patients. We compared the safety and efficacy of a losartan/hydrochlorothiazide (HCTZ) combination in controlling morning hypertension between Very-Elderly (≥75 years) and Young/Elderly patients (<75 years). This study was a subanalysis of the Morning Hypertension and Angiotensin Receptor Blocker/Hydrochlorothiazide Combination Therapy study, in which patients with morning hypertension (≥135/85 mmHg) received a 50-mg losartan/12.5-mg HCTZ combination tablet (combination therapy) or 100-mg losartan (high-dose therapy) for 3 months. High adherence rates and few adverse effects were observed in Very-Elderly patients receiving combination (n = 32) and high-dose (n = 34) therapies and in Young/Elderly patients receiving combination (n = 69) and high-dose (n = 66) therapies. Baseline morning systolic BP (SBP) was similar in both age groups receiving either therapy. Morning SBP was reduced by 20.2 and 18.1 mmHg with combination therapy and by 7.1 and 9.1 mmHg with high-dose therapy in the Very-Elderly and Young/Elderly patients, respectively. Morning BP target (<135/85 mmHg) was achieved in 40.6% and 55.1% by combination therapy and in 14.7% and 24.2% by high-dose therapy in the Very-Elderly and Young/Elderly patients, respectively. Neither therapy changed renal function and serum potassium in Very-Elderly patients. In conclusion, the losartan/HCTZ combination was safe and effective in controlling morning hypertension in Very-Elderly as well as Young/Elderly patients. In addition, combination therapy was also superior to high-dose therapy for lowering morning SBP in Very-Elderly patients. |
| first_indexed | 2024-03-11T23:44:27Z |
| format | Article |
| id | doaj.art-e96921c8f04a44b5bf9509b4f3b83ec9 |
| institution | Directory Open Access Journal |
| issn | 1064-1963 1525-6006 |
| language | English |
| last_indexed | 2024-03-11T23:44:27Z |
| publishDate | 2018-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Clinical and Experimental Hypertension |
| spelling | doaj.art-e96921c8f04a44b5bf9509b4f3b83ec92023-09-19T15:19:26ZengTaylor & Francis GroupClinical and Experimental Hypertension1064-19631525-60062018-04-0140326727310.1080/10641963.2017.13685361368536Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patientsHiroki Uchiwa0Hisashi Kai1Yoshiko Iwamoto2Takahiro Anegawa3Hidemi Kajimoto4Kenji Fukuda5Tsutomu Imaizumi6Yoshihiro Fukumoto7for the MAPPY Study InvestigatorsKurume University School of MedicineKurume University Medical CenterKurume University School of MedicineKurume University School of MedicineKurume University School of MedicineKurume University School of MedicineFukuoka International College of Health and WelfareKurume University School of MedicineMorning hypertension is an independent risk for cerebrovascular and cardiovascular events. Although the prevalence of morning hypertension increases with age, treatment of morning hypertension has not been established, particularly in Very-Elderly patients. We compared the safety and efficacy of a losartan/hydrochlorothiazide (HCTZ) combination in controlling morning hypertension between Very-Elderly (≥75 years) and Young/Elderly patients (<75 years). This study was a subanalysis of the Morning Hypertension and Angiotensin Receptor Blocker/Hydrochlorothiazide Combination Therapy study, in which patients with morning hypertension (≥135/85 mmHg) received a 50-mg losartan/12.5-mg HCTZ combination tablet (combination therapy) or 100-mg losartan (high-dose therapy) for 3 months. High adherence rates and few adverse effects were observed in Very-Elderly patients receiving combination (n = 32) and high-dose (n = 34) therapies and in Young/Elderly patients receiving combination (n = 69) and high-dose (n = 66) therapies. Baseline morning systolic BP (SBP) was similar in both age groups receiving either therapy. Morning SBP was reduced by 20.2 and 18.1 mmHg with combination therapy and by 7.1 and 9.1 mmHg with high-dose therapy in the Very-Elderly and Young/Elderly patients, respectively. Morning BP target (<135/85 mmHg) was achieved in 40.6% and 55.1% by combination therapy and in 14.7% and 24.2% by high-dose therapy in the Very-Elderly and Young/Elderly patients, respectively. Neither therapy changed renal function and serum potassium in Very-Elderly patients. In conclusion, the losartan/HCTZ combination was safe and effective in controlling morning hypertension in Very-Elderly as well as Young/Elderly patients. In addition, combination therapy was also superior to high-dose therapy for lowering morning SBP in Very-Elderly patients.http://dx.doi.org/10.1080/10641963.2017.1368536ang ii receptor blockersantihypertensive therapyclinical trialcombination therapydiureticshome blood pressure measurement |
| spellingShingle | Hiroki Uchiwa Hisashi Kai Yoshiko Iwamoto Takahiro Anegawa Hidemi Kajimoto Kenji Fukuda Tsutomu Imaizumi Yoshihiro Fukumoto for the MAPPY Study Investigators Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients Clinical and Experimental Hypertension ang ii receptor blockers antihypertensive therapy clinical trial combination therapy diuretics home blood pressure measurement |
| title | Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients |
| title_full | Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients |
| title_fullStr | Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients |
| title_full_unstemmed | Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients |
| title_short | Losartan/hydrochlorothiazide combination is safe and effective for morning hypertension in Very-Elderly patients |
| title_sort | losartan hydrochlorothiazide combination is safe and effective for morning hypertension in very elderly patients |
| topic | ang ii receptor blockers antihypertensive therapy clinical trial combination therapy diuretics home blood pressure measurement |
| url | http://dx.doi.org/10.1080/10641963.2017.1368536 |
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