Comparison of Aliskiren/Hydrochlorothiazide Combination Therapy With Hydrochlorothiazide Monotherapy in Older Patients With Stage 2 Systolic Hypertension: Results of the ACTION Study

• Published in: The journal of clinical hypertension (Greenwich, Conn.) Vol. 13; no. 3; pp. 162 - 169
• Main Authors: Basile, Jan, Babazadeh, Simon, Lillestol, Michael, Botha, Jaco, Yurkovic, Carol, Weitzman, Richard
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2011
• Subjects: Age Factors; Aged; Amides - therapeutic use; Analysis of Variance; Antihypertensive Agents - therapeutic use; Blood Pressure; Body Mass Index; Disease Progression; Diuretics - therapeutic use; Double-Blind Method; Drug Therapy, Combination; Female; Fumarates - therapeutic use; Health Status Indicators; Humans; Hydrochlorothiazide - therapeutic use; Hypertension - drug therapy; Hypertension - pathology; Male; Middle Aged; Original Paper; Original Papers; Systole; Treatment Outcome; United States; United States
• ISSN: 1524-6175; 1751-7176
• DOI: 10.1111/j.1751-7176.2010.00418.x

Patients with stage 2 systolic hypertension require sizable blood pressure (BP) reductions to achieve recommended targets. This randomized double‐blind study compared a single‐pill combination of the direct renin inhibitor aliskiren and hydrochlorothiazide (aliskiren/HCTZ) with HCTZ monotherapy in older patients (older than 55 years) with systolic BP ≥160 mm Hg and <200 mm Hg. After a 1‐ to 4‐week washout, 451 patients were randomized to once‐daily aliskiren/HCTZ 150/12.5 mg or HCTZ 12.5 mg for 1 week, and then double the doses for 7 weeks. Overall baseline BP was 168.8/91.4 mm Hg. At week 4 (primary) end point, aliskiren/HCTZ provided significantly greater BP reductions from baseline than HCTZ monotherapy (29.6/9.3 mm Hg vs 22.3/6.8 mm Hg) and resulted in a greater proportion of patients achieving BP goal of <140/90 mm Hg (51.1% vs 33.3%). Aliskiren/HCTZ therapy provides substantial BP reductions and may thus be a useful treatment option for older patients with stage 2 hypertension. J Clin Hypertens (Greenwich). 2011;13:162–169. © 2011 Wiley Periodicals, Inc.