The Role of Baseline Blood Pressure in Guiding Treatment Choice

Abstract

Background and Objective: Baseline blood pressure (BP) is a strong predictor of response to antihypertensive therapy and the patient’s ability to reach BP goals. The objective of this study was to evaluate the role of baseline BP as a determinant of systolic BP (SBP) and treatment outcome to assist in the choice of initial therapy. Methods: This was a double-blind, placebo-controlled clinical trial (n = 1329) in patients with essential hypertension (mean sitting diastolic BP [DBP] ≥95 mmHg and BP Results: The final SBP and DBP were lowest in the combination therapy groups across all baseline BPs and in subgroups of patients categorized by age (≥65 years, Conclusion: These secondary analyses suggest that characterizing the relationship between baseline SBP and achieved SBP can assist in the choice of initial therapy in a broad hypertensive population. Initial therapy with the combination of valsartan/HCTZ is more effective than monotherapy in lowering BP at all baseline BP levels, is consistent in this respect among all subgroups, and is well tolerated.