Author: Coca, Antonio

Source: Clinical Drug Investigation, Volume 28, Number 4, 2008 , pp. 211-220(10)

Publisher: Adis International

Abstract:

Hypertension is one of the leading risk factors for cardiovascular disease and represents a major health and economic burden. Most patients with high- or very high-risk hypertension have multiple cardiovascular risk factors with or without accompanying subclinical organ damage or established cardiovascular or renal disease. Patients with severe hypertension or with moderate hypertension and one to two additional risk factors have absolute 10-year risks of cardiovascular disease of 21-30% and 15-20%, respectively. Current European treatment guidelines recommend that antihypertensive therapy be initiated rapidly and aggressively in patients with high-risk hypertension. Most patients require two or more antihypertensive agents to achieve the strict blood pressure target of <130/80 mmHg. This article reviews the existing cost-effectiveness data on the use of angiotensin II receptor antagonists (blockers) [ARBs] in patients with high-risk hypertension. Aggressive ARB treatment of patients in the early (microalbuminuric) stages of diabetic nephropathy has a significant renoprotective effect, delaying the onset of overt (proteinuric) nephropathy. By slowing the progression of these patients to end-stage renal disease, substantial cost savings can be made. There is a paucity of cost-effectiveness data regarding the use of fixed-dose ARB plus thiazide diuretic combination therapies. Longitudinal cost-benefit studies of this attractive and efficacious first-line treatment option are needed.

Keywords: Angiotensin II receptor antagonists; Antihypertensives; Candesartan cilexetil/hydrochlorothiazide; Cost effectiveness; Cost of illness; Eprosartan/hydrochlorothiazide; Hypertension; Irbesartan; Irbesartan/hydrochlorothiazide; Losartan/hydrochlorothiazide; Olmesartan medoxomil/hydrochlorothiazide; Quality of life; Telmisartan/hydrochlorothiazide; Thiazide diuretics; Valsartan/hydrochlorothiazide

Document Type: Review article

Affiliations: 1: Hypertension Unit, Department of Internal Medicine, Institute of Medicine and Dermatology, Hospital Clínico, University of Barcelona, Barcelona, Spain

Publication date: 2008-01-01

Related content

• In this: publication
• By this: publisher
• In this Subject: Pharmacology
• By this author: Coca, Antonio

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers