Reaching the therapeutic goal in hypertension: results from the Canadian valsartan observational study. (Diovantage 4).
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BACKGROUND: Hypertension is a leading cause of death worldwide, and a major public health problem in Canada. Despite treatment guidelines and availability of therapies for blood pressure (BP) management, treatment of hypertension remains sub-optimal. OBJECTIVES: The objectives of this trial are to observe BP reduction, compliance and regimen changes 3 months after initiation of valsartan alone or with hydrochlorothiazide and optimized patient support. METHODS: As of February 2007, 34,033 patients with essential hypertension and prescribed valsartan alone or with hydrochlorothiazide for BP management were enrolled across 2,125 Canadian sites. Patients were newly diagnosed (38%), switched from another anti-hypertensive agent (38%) or received valsartan with or without hydrochlorothiazide as added therapy (20%). All patients were offered a home blood pressure monitor, access to nursing support and educational materials. Patients were assessed after 3 months for compliance, therapeutic response, and need for treatment modifications. RESULTS: In this interim analysis, after 3 months of treatment, 95% of patients reported being compliant with therapy and 59% achieved target BP (<140/90 mmHg). In the evaluable population (n=15,200), significant reductions in mean systolic (-18.5+/-19.3 mm/Hg, p<0.0001) and diastolic (-9.4+/-11.2 mmHg; p<0.0001) BP were observed. For patients not reaching target BP goals, no change in treatment was instituted in 55% of cases. CONCLUSIONS: This observational study demonstrates the benefits of valsartan alone or with hydrochlorothiazide and optimized patient support in BP management of patients with essential hypertension. Interestingly, no modification to the anti-hypertensive regimen was done in 55% of patients not having reached treatment goals.
