Recent landmark clinical trials: how do they modify the therapeutic paradigm?

Abstract:

:Despite intense investigation and clinical attention, many challenges remain in the management of the hypertensive patient. It is clear that hypertension remains inadequately controlled worldwide, with the control rate in the United States approximating 27%. Furthermore, several recent studies have underscored that it is frequently difficult to attain control at goal blood pressure (BP) with monotherapy and that adequate control of hypertension based on the newer more intensified BP goals necessitates multiple drug therapy. Indeed, in the recently published landmark trials of angiotensin I receptor antagonists, including the Irbesartan Diabetic Nephropathy Trial (IDNT) and Reduction of Endpoints in Non-insulin-dependent Diabetes Mellitus with the Angiotensin II Antagonist Losartan (RENAAL), multiple antihypertensive drugs were required to attain goal. A pivotal class of drug required to comprise this regimen is the calcium antagonists. For example, in RENAAL, 78% of patients randomized to losartan required add-on therapy with a calcium antagonist. Calcium antagonists are an important and often necessary component of this multiple drug regimen.

journal_name

Am J Hypertens

authors

Epstein M

doi

10.1016/s0895-7061(02)02948-5

subject

Has Abstract

pub_date

2002-07-01 00:00:00

pages

82S-84S

issue

7 Pt 2

eissn

0895-7061

issn

1941-7225

pii

S0895706102029485

journal_volume

15

pub_type

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