Higher cardiovascular risk and impaired benefit of antihypertensive treatment in hypertensive patients requiring additional drugs on top of randomized therapy: Is adding drugs always beneficial?

Yuqing Zhang, Xuezhong Zhang, Lisheng Liu, Yang Wang, Xinran Tang, Alberto Zanchetti

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: In antihypertensive treatment trials, when randomized therapies do not reach target, additional drugs are administered. However, patients requiring (add-on) or not requiring add-on therapy (no-add-on) may be at different cardiovascular risk and differently susceptible to benefits of antihypertensive treatment. METHODS AND RESULTS: The Felodipine Event Reduction study included 9711 Chinese hypertensive patients receiving 12.5 mg/day hydrochlorothiazide and randomized to associating either felodipine (5 mg/day) or placebo. Within 6 months, add-on therapy (further diuretic and other drugs) was required by 2185 patients, whereas 7243 did not require it. Despite significant SBP/DBP reductions by add-on therapy, outcome incidence remained much lower in no-add-on than in add-on patients: hazard ratios for various outcomes, after adjusting for baseline variables and blood pressure (BP) at time of add-on decision, were 0.22-0.368 (P always

Original languageEnglish
Pages (from-to)2202-2212
Number of pages11
JournalJournal of Hypertension
Volume30
Issue number11
DOIs
Publication statusPublished - Nov 2012

Keywords

  • antihypertensive therapy
  • cardiovascular disease
  • resistant hypertension
  • therapeutic strategies
  • trials

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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