24‐Hour Ambulatory Blood Pressure Response to Combination Valsartan/Hydrochlorothiazide and Amlodipine/Hydrochlorothiazide in Stage 2 Hypertension by Ethnicity: The EVALUATE Study

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Vol. 12; no. 11; pp. 833 - 840
• Main Authors: Wright Jr, Jackson T., Lacourcière, Yves, Samuel, Rita, Zappe, Dion, Purkayastha, Das, Black, Henry R.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-11-2010
• Subjects: Aged; Aged, 80 and over; Amlodipine - administration & dosage; Amlodipine - adverse effects; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - adverse effects; Blood Pressure - drug effects; Blood Pressure Monitoring, Ambulatory - statistics & numerical data; Double-Blind Method; Drug Combinations; Ethnicity; Female; Humans; Hydrochlorothiazide - administration & dosage; Hydrochlorothiazide - adverse effects; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Hypertension - physiopathology; Male; Original Papers; Racial Groups; Regression Analysis; Severity of Illness Index; Tetrazoles - administration & dosage; Tetrazoles - adverse effects; Treatment Outcome; Valine - administration & dosage; Valine - adverse effects; Valine - analogs & derivatives; Valsartan
• ISSN: 1524-6175; 1751-7176
• DOI: 10.1111/j.1751-7176.2010.00372.x

J Clin Hypertens (Greenwich).
Several studies reported racial/ethnic differences in blood pressure (BP) response to antihypertensive monotherapy. In a 10‐week study of stage 2 hypertension, 320/25 mg valsartan/hydrochlorothiazide (HCTZ) reduced ambulatory BP (ABP) significantly more effectively than 10/25 mg amlodipine/HCTZ. Results (post hoc analysis) are described in Caucasians (n=256), African Americans (n=79), and Hispanics (n=86). Compared with clinic‐measured BP (no significant treatment‐group differences in ethnic subgroups), least‐squares mean reductions from baseline to week 10 in mean ambulatory systolic BP (MASBP) and mean ambulatory diastolic BP (MADBP) favored valsartan/HCTZ over amlodipine/HCTZ in Caucasians (−21.9/−12.7 mm Hg vs −17.6/−9.5 mm Hg; P=.0004/P<.0001). No treatment‐group differences in MASBP/MADBP were observed in African Americans (−17.3/−10.6 vs −17.9/−9.5; P=.76/P=.40) or Hispanics (−17.9/−9.7 vs −14.2/−7.2; P=.20/P=.17). Based on ABP monitoring, valsartan/HCTZ is more effective than amlodipine/HCTZ in lowering ABP in Caucasians. In African Americans and Hispanics, both regimens are similarly effective. J Clin Hypertens (Greenwich). 2010;12:833–840.