Background Angiotensin receptor blockers (ARBs) are one of the five groups of antihypertensive agents recommended by the ESH/ESC as a first line pharmacotherapy of arterial hypertension and valsartan has a good reputation among these. ARB with thiazide diuretic is a preferred combination of antihypertensive drugs. The antihypertensive effect and tolerance of valsartan alone (Vanatex) and in combination with hydrochlorothiazide (Vanatex HCT) was evaluated in our trial.
Material and methods 82 hypertensive patients, who were not treated in the last 3 months were qualified for the trial. Every participant was given the 80 mg daily dose of valsartan. 4 weeks later patients with blood pressure exceeding 140/90 in office measurement were randomly subdivided into two groups, where valsartan dose was doubled or hydrochlorothiazide 12.5 mg dose was added. After another 4 weeks antihypertensive effect and tolerance were evaluated.
Results In a whole study population the antihypertensive effect of 11.3/9.3 mm Hg was obtained, i.e. 10.6/11.1 mm Hg in Vanatex 80 group, 11.3/8.0 mm Hg in Vanatex 160 group and 12.0/8.6 mm Hg in Vanatex HCT group. Significant reduction of blood pressure during the day and night was also proved in 24 hour ambulatory blood pressure monitoring, which was carried out at the beginning and the end of the trial. Blood pressure control was obtained in 44% of all participants. No adverse effects were observed.
Conclusion Valsartan (Vanatex) in monotherapy 80 and 160 mg daily and in combination with hydrochlorothiazide 12.5 mg (Vanatex HCT) shows a desirable antihypertensive effect, both during the day and the night. It is good to start
the monotherapy with Vanatex 80 mg daily. When a more effective therapy is needed adding a hydrochlorothiazide is more efficient (BP normalization in 58% of cases) than doubling
the valsartan dose (BP normalization in 38% of cases).