Original article Olmesartan medoxomil combined with hydrochlorothiazide improves 24-hour blood pressure control in moderate-to-severe hypertension

Background: Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has been shown to be more reliable than conventional measurements for hypertension assessment and the associated increased risk of cardiovascular events. Olmesartan/hydrochlorothiazide combination therapy has demonstrated increased blood pressure lowering over 24 hours compared with the component monotherapies. This prespecified pooled analysis of data from two trials investigated the effects of olmesartan/hydrochlorothiazide combination therapy and olmesartan monotherapy on 24-hour blood pressure control in patients with moderate-to-severe hypertension. Methods: After8weeks’ open-labelolmesartan40mg monotherapy, uncontrolled patients(mean troughseated blood pressure 90–115/140–180mmHg and 24-hour mean ambulatory diastolic blood pressure � 80mmHg with � 30% of daytime ambulatory diastolic blood pressure readings 485mmHg) were randomised to 8 weeks’ double-blind treatment with olmesartan 40mg or olmesartan/hydrochlorothiazide 20/12.5, 40/ 12.5 or 40/25mg (Study 1) or olmesartan/hydrochlorothiazide 20/25 or 40/25mg (Study 2). This prespecified analysis of ambulatory blood pressure was performed on patients from the full analysis set of pooled studies 1 and 2, restricted to patients who provided at least one valid ABPM measurement at baseline. Results: