Lessons from combination therapy in veterans affairs studies

Barry J Materson, Domenic J. Reda, David Williams

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

A subset of 102 patients of an original cohort of 1292 with stage 1 to 2 hypertension was characterized by having failed to achieve goal blood pressure (< 90 mm Hg diastolic) after treatment with two single antihypertensive drugs. These patients were given a combination of the two drugs on which they had failed to achieve blood pressure goal when they were administered as single-drug therapy. The drugs were hydrochlorothiazide, atenolol, captopril, diltiazem-SR, clonidine, and prazosin. We examined the responses in each of the drug combination categories by the order that the drugs were administered, by estimated total response rates for the combinations, and by age and race. The order of drug administration did have an effect for some of the drug pairs. This was of two types: 1) different results for each member of the pair, but the same combination result; and 2) different end result of the combination. An example of the first type is that prazosin had only a 6% response rate in patients who had failed on diltiazem, while diltiazem had a 22% response rate in patients who had failed on prazosin. Nevertheless, the combinations yielded the same total responses (86% and 34%) regardless of order. An example of the second type is that captopril-diltiazem was less effective in total response than diltiazem-captopril (88% v 97%). Differences were seen in the response to combinations in the race and age groups. There were ordering differences of type similar to those described above. We conclude that combination drug therapy is highly effective even when the individual components have failed and that some differences in response by order of drug administration may occur.

Original languageEnglish
JournalAmerican Journal of Hypertension
Volume9
Issue number12 SUPPL. 1
StatePublished - Dec 1 1996

Fingerprint

Diltiazem
Veterans
Prazosin
Pharmaceutical Preparations
Captopril
Drug Combinations
Blood Pressure
Therapeutics
Atenolol
Clonidine
Combination Drug Therapy
Antihypertensive Agents
Age Groups
Hypertension
Drug Therapy

Keywords

  • Antihypertensive therapy
  • Atenolol
  • Captopril
  • Clonidine
  • Combination therapy
  • Diltiazem
  • Hydrochlorothiazide
  • Hypertension
  • Prazosin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Materson, B. J., Reda, D. J., & Williams, D. (1996). Lessons from combination therapy in veterans affairs studies. American Journal of Hypertension, 9(12 SUPPL. 1).

Lessons from combination therapy in veterans affairs studies. / Materson, Barry J; Reda, Domenic J.; Williams, David.

In: American Journal of Hypertension, Vol. 9, No. 12 SUPPL. 1, 01.12.1996.

Research output: Contribution to journalArticle

Materson, BJ, Reda, DJ & Williams, D 1996, 'Lessons from combination therapy in veterans affairs studies', American Journal of Hypertension, vol. 9, no. 12 SUPPL. 1.
Materson BJ, Reda DJ, Williams D. Lessons from combination therapy in veterans affairs studies. American Journal of Hypertension. 1996 Dec 1;9(12 SUPPL. 1).
Materson, Barry J ; Reda, Domenic J. ; Williams, David. / Lessons from combination therapy in veterans affairs studies. In: American Journal of Hypertension. 1996 ; Vol. 9, No. 12 SUPPL. 1.
@article{ef0c1c05b91a4ebba754132916803b76,
title = "Lessons from combination therapy in veterans affairs studies",
abstract = "A subset of 102 patients of an original cohort of 1292 with stage 1 to 2 hypertension was characterized by having failed to achieve goal blood pressure (< 90 mm Hg diastolic) after treatment with two single antihypertensive drugs. These patients were given a combination of the two drugs on which they had failed to achieve blood pressure goal when they were administered as single-drug therapy. The drugs were hydrochlorothiazide, atenolol, captopril, diltiazem-SR, clonidine, and prazosin. We examined the responses in each of the drug combination categories by the order that the drugs were administered, by estimated total response rates for the combinations, and by age and race. The order of drug administration did have an effect for some of the drug pairs. This was of two types: 1) different results for each member of the pair, but the same combination result; and 2) different end result of the combination. An example of the first type is that prazosin had only a 6{\%} response rate in patients who had failed on diltiazem, while diltiazem had a 22{\%} response rate in patients who had failed on prazosin. Nevertheless, the combinations yielded the same total responses (86{\%} and 34{\%}) regardless of order. An example of the second type is that captopril-diltiazem was less effective in total response than diltiazem-captopril (88{\%} v 97{\%}). Differences were seen in the response to combinations in the race and age groups. There were ordering differences of type similar to those described above. We conclude that combination drug therapy is highly effective even when the individual components have failed and that some differences in response by order of drug administration may occur.",
keywords = "Antihypertensive therapy, Atenolol, Captopril, Clonidine, Combination therapy, Diltiazem, Hydrochlorothiazide, Hypertension, Prazosin",
author = "Materson, {Barry J} and Reda, {Domenic J.} and David Williams",
year = "1996",
month = "12",
day = "1",
language = "English",
volume = "9",
journal = "Journal of clinical hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "12 SUPPL. 1",

}

TY - JOUR

T1 - Lessons from combination therapy in veterans affairs studies

AU - Materson, Barry J

AU - Reda, Domenic J.

AU - Williams, David

PY - 1996/12/1

Y1 - 1996/12/1

N2 - A subset of 102 patients of an original cohort of 1292 with stage 1 to 2 hypertension was characterized by having failed to achieve goal blood pressure (< 90 mm Hg diastolic) after treatment with two single antihypertensive drugs. These patients were given a combination of the two drugs on which they had failed to achieve blood pressure goal when they were administered as single-drug therapy. The drugs were hydrochlorothiazide, atenolol, captopril, diltiazem-SR, clonidine, and prazosin. We examined the responses in each of the drug combination categories by the order that the drugs were administered, by estimated total response rates for the combinations, and by age and race. The order of drug administration did have an effect for some of the drug pairs. This was of two types: 1) different results for each member of the pair, but the same combination result; and 2) different end result of the combination. An example of the first type is that prazosin had only a 6% response rate in patients who had failed on diltiazem, while diltiazem had a 22% response rate in patients who had failed on prazosin. Nevertheless, the combinations yielded the same total responses (86% and 34%) regardless of order. An example of the second type is that captopril-diltiazem was less effective in total response than diltiazem-captopril (88% v 97%). Differences were seen in the response to combinations in the race and age groups. There were ordering differences of type similar to those described above. We conclude that combination drug therapy is highly effective even when the individual components have failed and that some differences in response by order of drug administration may occur.

AB - A subset of 102 patients of an original cohort of 1292 with stage 1 to 2 hypertension was characterized by having failed to achieve goal blood pressure (< 90 mm Hg diastolic) after treatment with two single antihypertensive drugs. These patients were given a combination of the two drugs on which they had failed to achieve blood pressure goal when they were administered as single-drug therapy. The drugs were hydrochlorothiazide, atenolol, captopril, diltiazem-SR, clonidine, and prazosin. We examined the responses in each of the drug combination categories by the order that the drugs were administered, by estimated total response rates for the combinations, and by age and race. The order of drug administration did have an effect for some of the drug pairs. This was of two types: 1) different results for each member of the pair, but the same combination result; and 2) different end result of the combination. An example of the first type is that prazosin had only a 6% response rate in patients who had failed on diltiazem, while diltiazem had a 22% response rate in patients who had failed on prazosin. Nevertheless, the combinations yielded the same total responses (86% and 34%) regardless of order. An example of the second type is that captopril-diltiazem was less effective in total response than diltiazem-captopril (88% v 97%). Differences were seen in the response to combinations in the race and age groups. There were ordering differences of type similar to those described above. We conclude that combination drug therapy is highly effective even when the individual components have failed and that some differences in response by order of drug administration may occur.

KW - Antihypertensive therapy

KW - Atenolol

KW - Captopril

KW - Clonidine

KW - Combination therapy

KW - Diltiazem

KW - Hydrochlorothiazide

KW - Hypertension

KW - Prazosin

UR - http://www.scopus.com/inward/record.url?scp=0030477921&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030477921&partnerID=8YFLogxK

M3 - Article

C2 - 8968432

AN - SCOPUS:0030477921

VL - 9

JO - Journal of clinical hypertension

JF - Journal of clinical hypertension

SN - 0895-7061

IS - 12 SUPPL. 1

ER -