First Line CombinAtion Therapy in the Treatment of Stage II and III Hypertension (FLASH).

Details

Serval ID
serval:BIB_89E3E14FB287
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
First Line CombinAtion Therapy in the Treatment of Stage II and III Hypertension (FLASH).
Journal
Frontiers in cardiovascular medicine
Author(s)
Spirk D., Noll S., Burnier M., Rimoldi S., Noll G., Sudano I.
ISSN
2297-055X (Print)
ISSN-L
2297-055X
Publication state
Published
Issued date
2020
Peer-reviewed
Oui
Volume
7
Pages
46
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Background: Lowering blood pressure (BP) leads to reduced risk of stroke, myocardial infarction, and cardiovascular mortality. Single-pill combination therapies may deliver better BP control than increasing the dose of monotherapies or using more drugs separately. Objectives: The aim of the present observational study was to investigate the real-life use and the effect of first line or replacement single-pill combination therapies containing irbesartan and hydrochlorothiazide (HCTZ) on systolic BP (SBP) control rate in patients with hypertension. Methods: Overall, 780 patients with moderate or severe hypertension either untreated (289; 37%) or uncontrolled (491; 63%) with previous therapy were included in the "First Line CombinAtion Therapy in the Treatment of Stage II and III Hypertension" (FLASH) prospective Swiss national-wide cohort study. All recruited patients received single-pill antihypertensive combination therapy containing HCTZ and irbesartan. BP was measured at baseline and after 8-weeks follow-up according to guidelines. Results: Mean reductions in office systolic/diastolic BP (SBP/DBP) were 23.7 ± 13.7/11.7 ± 8.5 mmHg, with reductions of 26.9 ± 14.1/13.0 ± 8.8 mmHg or 21.8 ± 13.1/11.0 ± 8.3 mmHg when the single-pill combination of irbesartan/HCTZ was given as first line or replacement treatment, respectively (p < 0.001 for differences between first line and replacement treatment in both SBP and DBP). The guidelines-recommended goals were reached in 368 (47%), 492 (63%), and 312 (40%) patients for SBP, DBP, and SBP/DBP, respectively. The SBP control rate was higher when the combination was used as first line treatment (52 vs. 44%; p = 0.043). Overall, 145 adverse events were recorded; hypotension in 12 (1.5%) cases, hypokalaemia in 9 (1.2%), and hyperkalaemia in 3 (0.4%). Conclusions: The single-pill combination of irbesartan/HCTZ was well-tolerated and achieved substantial reductions in both systolic and diastolic BP. The SBP control rate was greater when the combination was prescribed as first line treatment as suggested by recent ESC/ESH guidelines.
Keywords
blood pressure, goal attainment, hydrochlorothiazide, hypertension, single-pill combination therapy
Pubmed
Open Access
Yes
Create date
25/04/2020 20:42
Last modification date
23/02/2022 7:36
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