Olmesartan medoxomil 20mg / Hydrochlorothiazide 25mg tablets

BackgroundThiazide diuretics are commonly prescribed for the treatment of hypertension (HTN). However, the comparative efficacy and safety of hydrochlorothiazide (HCTZ) versus chlorthalidone (CTD) in managing patients with HTN remain unclear.Materials and methodsA comprehensive literature search was performed using two electronic databases, MEDLINE and Cochrane, from their inception through November 2024. The aim was to identify randomized controlled trials or observational double-arm studies assessing the effects of HCTZ versus CTD on cardiovascular outcomes and safety in patients with HTN. Outcomes were reported as hazard ratios (HRs) with 95% confidence intervals (CIs), and analyses were conducted using a random effects model. A P-value of ResultsOf the 409 articles identified in the initial search, six relevant studies were included in the final analysis. No significant differences were observed between the HCTZ and CTD arms for cardiovascular outcomes, including major adverse cardiovascular events, myocardial infarction, stroke, hospitalization for heart failure, and angina. However, patients receiving CTD experienced significantly higher rates of hypokalemia and hyponatremia compared to those on HCTZ. The risk of acute kidney injury did not differ significantly between the two groups.ConclusionHCTZ and CTD showed comparable efficacy in terms of cardiovascular outcomes. Nevertheless, HCTZ appeared to have a safer profile, with a lower incidence of electrolyte imbalances, such as hypokalemia and hyponatremia, compared to CTD.

Abstract licence: CC BY-SA

BackgroundThis study was to evaluate the efficacy and safety of triple fixed-dose combination (FDC) therapy with olmesartan medoxomil (OM) 20  mg, amlodipine (AML) 5 mg, and hydrochlorothiazide (HCTZ) 12.5 mg (OM/AML/HCTZ 20/5/12.5) in Korean patients with moderate hypertension not controlled with dual FDC therapy (OM/HCTZ 20/12.5).MethodsIn this multicenter, randomized, double-blind, parallel-group study, Korean patients aged 20 to 75 years with stage 2 hypertension who had a mean seated diastolic blood pressure (msDBP) ≥100 mmHg were enrolled when their BP was uncontrolled [mean seated systolic BP (msSBP)/msDBP >140/90 mmHg or msSBP/msDBP >130/80 mmHg with diabetes or chronic kidney disease] with 4-week dual FDC therapy (OM/HCTZ 20/12.5). The patients were randomized to receive either OM/AML/HCTZ 20/5/12.5 or OM/HCTZ 20/12.5 once daily for 8 weeks. At the end of 8 weeks, patients with uncontrolled BP were assigned to receive either OM/AML/HCTZ 40/5/12.5 or OM/AML/HCTZ 20/5/12.5 in an additional 8-week open-label extension period.ResultsA total of 623 patients received a 4-week run-in treatment with OM/HCTZ, 341 patients were randomized, and finally, 167 patients in the OM/AML/HCTZ group and 171 patients in the OM/HCTZ group were analyzed for the full analysis set. Non-responders after the 8 weeks of double-blind treatment continued the 8-week open-label treatment with OM/AML/HCTZ 40/5/12.5 mg (n = 32) or OM/AML/HCTZ 20/5/12.5 mg (n = 71). After 8 weeks of double-blind treatment, the changes in msDBP were −9.50 (8.46) mmHg in the OM/AML/HCTZ group and −4.23 (7.41) mmHg in the OM/HCTZ group (both p < 0.0001 vs. baseline; p < 0.0001 between groups). The response rates for both msSBP and msDBP at week 8 were 65.27 % in the OM/AML/HCTZ group and 37.43 % in the OM/HCTZ group (p < 0.0001 between groups). The response rates for both msSBP and msDBP at week 16 after open-label treatment were 18.75 % in the OM/AML/HCTZ 40/5/12.5 group and 46.48 % in the OM/AML/HCTZ 20/5/12.5 group (p = 0.0073 between groups). All medications were well tolerated.ConclusionIn Korean patients with moderate hypertension not controlled with dual FDC therapy (OM/HCTZ 20/12.5) as first-line therapy, switching to triple FDC therapy (OM/AML/HCTZ 20/5/12.5) was associated with significant BP reductions and greater achievement of BP goals, and was well tolerated (ClinicalTrials.gov Identifier: NCT01838850).

Abstract licence: CC BY-NC 4.0