Comparison of efficacy and safety between third‐dose triple and third‐dose dual antihypertensive combination therapies in patients with hypertension

Author:

Sung Ki‐Chul1ORCID,Hong Soon Jun2,Rhee Moo‐Yong3ORCID,Jeong Myung‐Ho4ORCID,Kim Dae‐Hee5,Lim Sang‐Wook6,Park Kyungil7,Lee Jin Bae8,Kim Seok‐Yeon9,Cho Jin‐Man10,Cho Goo‐Yeong11,Heo Jung‐Ho12,Kim Sang‐Hyun13,Lee Hae‐Young14ORCID,Kim Weon15,Cho Deok‐Kyu16,Park Sungha17ORCID,Shin Jinho18ORCID,Pyun Wook‐Bum19ORCID,Kwon Kihwan20,Rha Seung‐Woon21,Jung Jin‐A22

Affiliation:

1. Division of Cardiology Department of Internal Medicine Kangbuk Samsung Hospital Sungkyunkwan University College of Medicine Seoul Republic of Korea

2. Department of Cardiology Cardiovascular Center Korea University Anam Hospital Korea University College of Medicine Seoul Republic of Korea

3. Cardiovascular Center Dongguk University Ilsan Hospital Goyang‐si Gyeonggi Republic of Korea

4. Department of Cardiology Chonnam National University Hospital Gwangju Republic of Korea

5. Division of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea

6. Cardiology Division Cardiac center CHA Bundang medical center CHA University Seongnam Republic of Korea

7. Dong‐A University Hospital Dong‐A University College of Medicine Busan Republic of Korea

8. Department of Cardiology Daegu Catholic University Medical Center Daegu Republic of Korea

9. Department of Cardiology Seoul Medical Center Seoul Republic of Korea

10. Cardiovascular Center Kyung Hee University Hospital at Gangdong Seoul Republic of Korea

11. Cardiovascular Center Seoul National University Bundang Hospital Seongnam Republic of Korea

12. Division of Cardiology Kosin University Gospel Hospital Kosin University College of Medicine Busan Republic of Korea

13. Boramae Hospital Seoul University College of Medicine Seoul Republic of Korea

14. Department of internal medicine Division of Cardiology Seoul National University Hospital Seoul National University College of Medicine Seoul Republic of Korea

15. Department of Internal Medicine Kyung Hee University Medical Center Kyung Hee University Seoul Republic of Korea

16. Yonsei University College of Medicine and Cardiovascular Center Yongin Severance Hospital Yongin Republic of Korea

17. Department of Cardiology Severance Hospital Yonsei University College of Medicine Seoul Republic of Korea

18. Division of Cardiology Department of Internal Medicine Hanyang University College of Medicine Seoul Republic of Korea

19. Division of Cardiology Department of Internal Medicine Ewha Womans University Seoul Hospital Seoul Republic of Korea

20. Division of Cardiology Department of Internal Medicine Ewha Womans University Mokdong Hospital Seoul Republic of Korea

21. Department of Internal Medicine Korea University Guro Hospital Seoul Republic of Korea

22. Hanmi Pharm.Co.,Ltd. Songpa‐gu Seoul Republic of Korea

Abstract

AbstractWe compared the efficacy and safety of third‐standard‐dose triple and third‐standard‐dose dual antihypertensive combination therapies in patients with mild to moderate hypertension. This was a phase II multicenter, randomized, double‐blind, parallel‐group trial. After a 4‐week placebo run‐in period, 245 participants were randomized to the third‐dose triple combination (ALC group; amlodipine 1.67 mg + losartan potassium 16.67 mg + chlorthalidone 4.17 mg) or third‐dose dual combination (AL group; amlodipine 1.67 mg + losartan potassium 16.67 mg, LC group; losartan potassium 16.67 mg + chlorthalidone 4.17 mg, AC group; amlodipine 1.67 mg + chlorthalidone 4.17 mg) therapy groups and followed up for 8 weeks. The mean systolic blood pressure (BP) reduction was ‐18.3 ± 13.2, ‐13.0 ± 13.3, ‐16.3 ± 12.4, and ‐13.8 ± 13.2 mmHg in the ALC, AL, LC, and AC groups, respectively. The ALC group showed significant systolic BP reduction compared to the AL and AC groups at weeks 4 (P = .010 and P = .018, respectively) and 8 (P = .017 and P = .036, respectively). At week 4, the proportion of systolic BP responders was significantly higher in the ALC group (42.6%) than in the AL (22.0%), LC (23.3%), and AC (27.1%) groups (P = .013, P = .021, and P = .045, respectively). At week 8, the proportion of systolic and diastolic BP responders was significantly higher in the ALC group (59.7%) than in the AL (39.3%) and AC (42.4%) groups (P = .022 and P = .049, respectively) at week 8. Third‐standard‐dose triple antihypertensive combination therapy demonstrated early effective BP control compared to third‐standard‐dose dual combination therapies, without increasing adverse drug reactions in patients with mild‐to‐moderate hypertension.

Publisher

Wiley

Subject

Cardiology and Cardiovascular Medicine,Endocrinology, Diabetes and Metabolism,Internal Medicine

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