Blood pressure control with valsartan and hydrochlorothiazide in clinical practice: the MACHT Observational Study.

Abstract

Reduction of blood pressure (BP) in hypertensive patients reduces cardiovascular risk, with substantial reductions in death from cardiovascular disease and all-cause mortality. This observational study assessed BP reduction in 17,242 patients with uncontrolled hypertension (mean baseline BP 165.4/95.8 mmHg) treated in clinical practice with a combination of valsartan 160 mg and hydrochlorothiazide (HCTZ) 12.5 mg by non-hospital specialists and general practitioners. BP was recorded at baseline and at 1 and 3 months with efficacy assessed as BP change from baseline at last timepoint. Mean systolic and diastolic BP reductions of -27.0 mmHg and -13.7 mmHg were achieved overall, with greater reductions in previously untreated patients or in those with a higher baseline BP. Response rates were high overall (78%), and in both formerly antihypertensive naive patients (87%) and in pre-treated patients (76%). The combination of valsartan and HCTZ was well tolerated with a discontinuation rate due to adverse events of <0.4%. In routine clinical practice, valsartan plus HCTZ is effective at reducing BP with high response rates despite patients having previously uncontrolled hypertension, and regardless of individual risk status. The low adverse event rates confirm the good tolerability profile and suitability for chronic use of antihypertensive regimens containing valsartan.