Effectiveness of add-on therapy with amlodipine in hypertensive patients receiving valsartan

Abstract

Objective. To describe the real-world effectiveness of amlodipine add-on therapy for hypertensive patients receiving valsartan. Methods. Retrospective cohort study based on USA electronic medical records. The study population included hypertensive patients who, between January 1998 and December 2005, were receiving valsartan and subsequently initiated add-on therapy with amlodipine. Change in systolic blood pressure (SBP)/diastolic blood pressure (DBP), and attainment of goal SBP/DBP (i.e. <140/90 mmHg), were examined based on last available reading prior to day 180 following initiation of amlodipine. Results. Mean (±SD) baseline SBP/DBP of study subjects (n = 155) was 152.5 (±21.1)/84.0 (±13.5) mmHg. Add-on therapy with amlodipine reduced SBP by 13.3 mmHg (95% CI 9.4-17.1) and DBP by 6.1 mmHg (95% CI 4.2-8.1). Among patients with baseline SBP/DBP ≥160/100 mmHg (n=69), corresponding reductions were 28.8 mmHg (95% CI 23.4-34.2) and 11.4 mmHg (95% CI 8.4-14.3). Goal SBP/DBP was achieved by 46% (95% CI 37.7-55.6) of subjects; rates of goal attainment were similar for patients with and without diabetes or chronic kidney disease, and those aged ≥65 years versus younger. Conclusions. Adding amlodipine to valsartan for treatment of hypertension results in clinically meaningful reductions in blood pressure, on an overall basis and in high-risk subgroups who may benefit the most from blood pressure control.