Managing hypertension: how effective is fixed dose combination of amlodipine/valsartan?

This study investigated a fixed-dose combination of amlodipine and valsartan (AML/VAL) for the treatment of hypertension.

They found that AML/VAL reduced blood pressure in patients with poor response to VAL alone.

Hypertension or high blood pressure (BP) is a common condition. Managing BP levels in patients with hypertension can be difficult. Combining drugs that work differently can be effective in managing BP. These types of drugs are diuretics, angiotensin II receptors blockers (ARBs) and calcium channel blockers (CCBs). Hydrochlorothiazide (HCTZ) is a diuretic. It reduces the volume of blood in the vessels and BP is lowered. Valsartan (VAL) is an ARB. As a result, blood vessels relax and BP is reduced. Amlodipine (AML) is a CCB. By blocking calcium, blood pressure is reduced.

Combining these drugs is useful to manage BP. It is unclear if a combination of AML/VAL or VAL/HCTZ is more effective than VAL alone.

This study included 228 patients with hypertension. Patients took VAL (160 mg) alone for 4 weeks. Patients with an inadequate response to VAL were randomly assigned to fixed-dose combinations. For 8 weeks, patients took a fixed-dose of AML/VAL (5/160 mg) or VAL/HCTZ (160/12.5 mg) once daily. Blood pressure was measured at the beginning and end of the trial.

Patients taking AML/VAL or VAL/HCTZ had significant reductions in diastolic BP (the bottom number of the reading, meaning the pressure in arteries when the heart rests between beats) compared to baseline. The effectiveness of AML/VAL was similar to VAL/HCTZ in reducing systolic BP (the top number, meaning the pressure in the arteries when the heart contracts).

More patients in the AML/VAL group achieved a systolic BP below 140mmHg or a diastolic BP below 90mmHg (84.3%) at the end of 8 weeks compared to the VAL/HCTZ group (71.3%). There was no significant difference in the serious adverse events or drug reactions in both groups. 

The authors concluded that AML/VAL reduced blood pressure in patients with poor response to VAL alone.

This was a relatively short study. Long-term studies are needed to determine the effectiveness and safety of fixed-dose combinations such as AML/VAL.

If you have any concerns regarding BP management, please consult with your physician.