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- W1986478633 abstract "Under the current stepped care paradigm, fewer than 20% of patients with diabetes mellitus (DM) and hypertension (HTN) attain goal blood pressure of <130/80 mmHg. We performed a randomized, double blind trial to test the safety and efficacy of initial combination therapy with losartan potassium/hydrochlorothiazide (L/H) versus monotherapy with ramipril (RAM) in this high risk patient population. Patients with DM and HTN were randomized to L/H (50mg/12.5mg force titrated to 100mg/25mg at 4 weeks, with sham titration at weeks 2 and 6; n = 151) or RAM (force titrated every 2 weeks, by doubling the dose, from 2.5 to 20mg/day; n = 153) for a total of 8 weeks double blind treatment. The primary endpoint was the proportion of patients achieving goal diastolic blood pressure (DBP) of ≤80 mmHg at 4 weeks. The secondary endpoint was the proportion of patients achieving goal systolic blood pressure (SBP) of ≤130 mmHg at 4 weeks. L/H was more effective than RAM in achieving goal blood pressures. At 4 weeks, mean DBP had fallen (mean ± SD) 10.2 ± 7.4 mmHg in L/H and 6.4 ± 6.8 in RAM (p<.001) and SBP had fallen 15.4 ± 13.1 mmHg in L/H compared to 9.2 ± 10.2 mmHg, in RAM (p<0.001). Drug related adverse experiences occurred in 10.3% of L/H and 12.7% of RAM patients (n.s.). Initial combination therapy with L/H was more effective than titrated monotherapy with RAM in the treatment of DM patients with HTN as measured by attainment of both diastolic and systolic blood pressure goals, and there was no difference in the incidence of adverse events between groups. (See Table)" @default.
- W1986478633 created "2016-06-24" @default.
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- W1986478633 date "2004-05-01" @default.
- W1986478633 modified "2023-09-26" @default.
- W1986478633 title "Treatment of hypertension in patients with diabetes mellitus: initial losartan/hydrochlorothiazide combination versus ramipril monotherapy" @default.
- W1986478633 doi "https://doi.org/10.1016/j.amjhyper.2004.03.275" @default.
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