Langtry H D, McClellan K J
Adis International Limited, Auckland, New Zealand.
Drugs. 1999 May;57(5):751-5; discussion 756-8. doi: 10.2165/00003495-199957050-00008.
Valsartan/hydrochlorothiazide (HCTZ) combines an angiotensin II AT1 receptor blocker with a thiazide diuretic to produce additive blood pressure reductions without major effects on heart rate. HCTZ did not significantly alter valsartan pharmacokinetics; during combination therapy, HCTZ pharmacokinetics differed from those seen with HCTZ monotherapy. In clinical trials in patients with essential hypertension, adding HCTZ 12.5 or 25 mg/day to valsartan 80 mg/day resulted in a greater blood pressure reduction than increasing the valsartan dosage from 80 to 160 mg/day. The valsartan/HCTZ combination was generally more effective than either drug given alone. Efficacy of the combination was maintained during up to 3 years of treatment. Valsartan/HCTZ was well tolerated in both short and long term trials. The most common adverse events were dizziness, headache and fatigue. The overall incidence of adverse events with the combination was similar to that with placebo. HCTZ-induced hypokalaemia was less common during combination therapy.
缬沙坦/氢氯噻嗪（HCTZ）将血管紧张素II AT1受体阻滞剂与噻嗪类利尿剂联合使用，可使血压进一步降低，且对心率无显著影响。氢氯噻嗪不会显著改变缬沙坦的药代动力学；在联合治疗期间，氢氯噻嗪的药代动力学与单药治疗时不同。在原发性高血压患者的临床试验中，将氢氯噻嗪12.5或25毫克/天添加到缬沙坦80毫克/天中，比将缬沙坦剂量从80毫克/天增加到160毫克/天能使血压降低更多。缬沙坦/氢氯噻嗪联合用药通常比单独使用任何一种药物更有效。联合用药的疗效在长达3年的治疗期间得以维持。在短期和长期试验中，缬沙坦/氢氯噻嗪的耐受性均良好。最常见的不良事件为头晕、头痛和疲劳。联合用药不良事件的总体发生率与安慰剂相似。联合治疗期间，氢氯噻嗪引起的低钾血症较少见。
