Comparison of aliskiren/hydrochlorothiazide combination therapy with hydrochlorothiazide monotherapy in older patients with stage 2 systolic hypertension: results of the ACTION study.

Author(s): Basile J, Babazadeh S, Lillestol M, Botha J, Yurkovic C, Weitzman R

Affiliation(s): Ralph H Johnson VA Medical Center and Medical University of South Carolina, Charleston, SC 29401, USA. basilejn@musc.edu

Publication date & source: 2011-03, J Clin Hypertens (Greenwich)., 13(3):162-9. Epub 2011 Jan 25.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Patients with stage 2 systolic hypertension require sizable blood pressure (BP) reductions to achieve recommended targets. This randomized double-blind study compared a single-pill combination of the direct renin inhibitor aliskiren and hydrochlorothiazide (aliskiren/HCTZ) with HCTZ monotherapy in older patients (older than 55 years) with systolic BP >/=160 mm Hg and <200 mm Hg. After a 1- to 4-week washout, 451 patients were randomized to once-daily aliskiren/HCTZ 150/12.5 mg or HCTZ 12.5 mg for 1 week, and then double the doses for 7 weeks. Overall baseline BP was 168.8/91.4 mm Hg. At week 4 (primary) end point, aliskiren/HCTZ provided significantly greater BP reductions from baseline than HCTZ monotherapy (29.6/9.3 mm Hg vs 22.3/6.8 mm Hg) and resulted in a greater proportion of patients achieving BP goal of <140/90 mm Hg (51.1% vs 33.3%). Aliskiren/HCTZ therapy provides substantial BP reductions and may thus be a useful treatment option for older patients with stage 2 hypertension. (c) 2011 Wiley Periodicals, Inc.