Managing Hypertension With Olmesartan-Based Combination Therapy

Blood pressure control remains an unmet clinical need; only approximately half of patients achieve blood pressure targets, and of those, the majority require combination and double or triple therapies. Michel Burnier, MD, and colleagues reviewed use of olmesartran-based combinations to improve blood pressure control in patients with hypertension. Results were reported online in High Blood Pressure & Cardiovascular Prevention [].

International guidelines recommend the use of drugs with complementary mechanisms of action, and, in particular, the combination of renin-angiotensin system (RAS) inhibitors, calcium, channel blockers (CCBs), and diuretics. Olmesartan (OM), an angiotensin receptor blocker, is available as monotherapy and in dual and triple single-pill combinations (SPCs) with amlodipine (AML) and/or hydrochlorothiazide (HCTZ).

Results of phase 3 and 4 studies, as well as real-world studies, have demonstrated the benefits of combining OM with either AML or HCTZ for blood pressure control and achievement of blood pressure goals in the general population and in subgroups of patients with hypertension, including the elderly, and those with diabetes, chronic kidney disease, and/or obesity.

Ambulatory blood pressure monitoring studies designed to assess 24-hour blood pressure have also shown that dual (and triple) OM-based SPCs induce a more sustained reduction in blood pressure compared with placebo and monotherapy. In addition, triple OM-based SPC has been shown to improve therapeutic adherence in patients with hypertension compared with free combinations.

“The availability of OM combined with HCTZ, AML, or both at different dosages makes it a valuable option to customize therapy based on the levels of blood pressure and the clinical characteristics of hypertensive patients,” the researchers said.