scholarly journals The combination therapy in arterial hypertension: opportunities of the fixed combination of irbesartan andhydrochlorothiazide(Koaprovel’)

2014 ◽  
Vol 11 (3) ◽  
pp. 43-48
Author(s):  
O D Ostroumova ◽  
T F Guseva ◽  
O V Bondarets

The article deals with the various aspects of the combinationtherapyin arterial hypertension. We showed the complementary effects and benefits of the combination of angiotensin II receptor antagonistsand diuretics; also we described clinical caseswhere thiscombination therapy is forpriority use. In detail we analysed the literature data on the efficacy and safety of combination of irbesartan and hydrochlorothiazide, including long-term use.

2013 ◽  
Vol 10 (2) ◽  
pp. 53-56
Author(s):  
O D Ostroumova ◽  
A A Zykova ◽  
T A Polosova ◽  
O V Bondarets

The paper gives the data of Russian guidelines for the diagnosis and approaches to treating metabolic syndrome. It considers the choice of antihypertensive drugs in the treatment of hypertensive patients with metabolic syndrome. The benefits of angiotensin II receptor blockers are shown. The results of a number of trials evaluating the efficacy and safety of irbesartan used to manage arterial hypertension in metabolic syndrome are analyzed.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Dae Wook Lee ◽  
Mira Jung ◽  
Hye Won Wang ◽  
Zainah Khan ◽  
Philippe Pinton

Background. Hypertension (HTN) is the leading risk factor for cardiovascular mortality globally. The WHO estimates a 60% increase in Asian HTN patients between 2000 and 2025. Numerous studies have compared safety and efficacy between antihypertensive classes, but in-class comparisons of angiotensin II receptor blockers (ARBs) in combination therapy (CT) (fixed-dose combination or dual combination) with a calcium channel blocker (CCB) are lacking in Asia. Objective. To compare the efficacy and safety of the various ARB-amlodipine CTs and amlodipine (AML) monotherapy for treatment of HTN in Asian population. Methods. A systematic literature review sourced Asian randomized controlled trials (RCTs) from PubMed and Cochrane Libraries to inform a network meta-analysis (NMA). We considered the ARB-AML CT. The primary efficacy and safety endpoints were short-term (8–12 weeks) treatment response and treatment-emergent adverse events (TEAEs), respectively. AML monotherapy was used as a comparator to allow for indirect treatment effect estimation in the absence of direct RCTs evidence comparing the different ARB-AML CTs. Results. The analysis included 1198 Asian HTN patients from seven studies involving six ARB-AML CTs: azilsartan (AZL), candesartan (CAN), fimasartan (FIM), losartan (LOS), olmesartan (OLM), and telmisartan (TEL). Compared to AML monotherapy, CT of AZL-AML had five times greater odds of prompting a treatment response (OR 5.2, 95% CI: 2.5, 11.2), while CAN-AML had 3.9 (95% CI: 2.5, 6.4), FIM-AML had 3.4 (95% CI: 1.4, 8.5), TEL-AML had 3.3 (95% CI: 1.6, 7.1), OLM-AML had 2.7 (95% CI: 1.6, 5.0), and LOS-AML had 2.0 (95% CI: 0.6, 7.3). All ARB-AML CTs had safety profiles comparable to AML monotherapy except TEL-AML, which had significantly lower odds of TEAEs (0.26 (95% CI: 0.087, 0.70)). Conclusion. This study suggests that all ARB-AML CTs compared favorably to AML monotherapy regarding short-term treatment response in uncomplicated HTN patients of Asian origin. AZL-AML prompted the most favorable treatment response. Safety profiles among the ARB-AML CTs were largely comparable. Due to the limited study size and small number of trials (direct evidence), our findings should best be interpreted as an exploratory effort importance to inform future research direction.


2011 ◽  
Vol 12 (1S) ◽  
pp. 9-17
Author(s):  
Francesco Vittorio Costa

The search for a more specific and complete blockade of the hypertensive effects of angiotensin and of better tolerability than ACE-inhibitors has led to the development of angiotensin II receptor blockers (ARBs). ARBs have been evaluated in several large studies in terms of efficacy and safety in reducing blood pressure, as well as for cardiovascular and renal protection. Among angiotensin II receptor blockers, valsartan and losartan have the greatest number of therapeutic indications. In light of the costs related to cardiovascular disorder valsartan represents a potential long-term health cost saving strategy. Furthermore valsartan shows one of the lowest costs for patient achieving blood pressure goals and the higher level of persistence in its class.


2021 ◽  
pp. 2102024
Author(s):  
Marius M. Hoeper ◽  
Christine Pausch ◽  
Ekkehard Grünig ◽  
Gerd Staehler ◽  
Doerte Huscher ◽  
...  

BackgroundSince 2015, the European pulmonary hypertension guidelines recommend the use of combination therapy in most patients with pulmonary arterial hypertension (PAH). However, it is unclear to what extend this treatment strategy is adopted in clinical practice and if it is associated with improved long-term survival.MethodsWe analysed data from COMPERA, a large European pulmonary hypertension registry, to assess temporal trends in the use of combination therapy and survival of patients with newly diagnosed PAH between 2010 and 2019. For survival analyses, we look at annualized data and at cumulated data comparing the periods 2010–2014 and 2015–2019.ResultsA total of 2,531 patients were included. The use of early combination therapy (within 3 months after diagnosis) increased from 10.0% in patients diagnosed with PAH in 2010 to 25.0% in patients diagnosed with PAH in 2019. The proportion of patients receiving combination therapy 1 year after diagnosis increased from 27.7% to 46.3%. When comparing the 2010–2014 and 2015–2019 periods, 1-year survival estimates were similar (89.0% [95% CI, 87.2%, 90.9%] and 90.8% [95% CI, 89.3%, 92.4%]), respectively, whereas there was a slight but non-significant improvement in 3-year survival estimates (67.8% [95% CI, 65.0%, 70.8%] and 70.5% [95% CI, 67.8%, 73.4%]), respectively.ConclusionsThe use of combination therapy increased from 2010 to 2019, but most patients still received monotherapy. Survival rates at 1 year after diagnosis did not change over time. Future studies need to determine if the observed trend suggesting improved 3-year survival rates can be confirmed.


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