Reaching the therapeutic goal in hypertension: results from the Canadian valsartan observational study. (Diovantage 4).

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.