The combination of an angiotensin receptor blocker plus hydrochiorothiazide is a more cost-effective treatment for hypertension than an angiotensin receptor blocker alone, Daniel E. Hilleman, Pharm.D., said in a poster presentation at the annual meeting of the American Society of Hypertension.
Investigators analyzed data on 3,883 patients from 14 randomized, controlled trials that evaluated three commercially available fixed-dose combinations of hydrochiorothiazide and an angiotensin receptor blocker (ARB)--losartan, telmisartan, or valsartan, They calculated costeffectiveness using annual average wholesale prices and pooled estimates of blood pressure reductions.
Combining low-dose thiazide diuretics with most classes of antihypertensive agents increases efficacy and adds little toxicity. The results suggest that the same can be said for ARBs, said Dr. Hilleman of Creighton University in Omaha, Neb.
All fixed-dose combinations of an ARB plus hydrochiorothiazide were more cost effective than using an ARB alone, based on the cost per millimeter of mercury of systolic and diastolic blood pressure as well as the cost per percentage of response rate. The most cost-effective combination was telmisartan plus hydrochlorothiazide, based on both blood pressure reduction and response rate.
Only 2% of patients discontinued any of the drugs because of adverse effects.
COPYRIGHT 2002 International Medical News Group
COPYRIGHT 2002 Gale Group
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