December 2016 Special Issue Vol. 2(4), pp. 032-038
Copyright © 2016 Transcontinental Publishers


Full Length Research Paper

An Observational Study to evaluate the behavior of physicians focusing on the preference patterns of ARB/HCTZ combinations containing high dose (25 mg) diuretic for the treatment of hypertension in Saudi Arabia


Consultant Cardiologist King Fahad Cardiology Center, Assistant Professor King Saud University King Saud University, P.O. Box 7805(38) Riyadh 11472, Saudi Arabia.

E-mail:; Tel: +966504135042

Accepted 29 December, 2016  


The Hypertension Guidelines 2007 ESH/ESC recommend a two drug combination therapy in patients failing blood pressure goal under monotherapy. The objective of this study is to evaluate the preference patterns of ARB/ high dose HCTZ combinations in the treatment of hypertension in patients uncontrolled by at least 4 to 8 weeks full dose ARB monotherapy. This was a prospective, non-interventional study with a sample size 529 recruited from 81 private and institutional sectors from internal medicine or general practice in Saudi Arabia, during January 2011 to January 2014.Patients classified as uncontrolled by previous full-dose ARB-based monotherapy and to whom the treating physician decided to prescribe ARB/HCTZ combination therapy were eligible for inclusion. Blood pressure was measured at baseline and subsequent visits, up to 4 months. Subgroup analysis was performed based on previous treatment, existing risk factors, gender, and age. All statistical tests were performed using two-tailed tests at a 5% level of significance. The mean reduction of systolic and diastolic blood pressure from baseline to last visit for all patients is 28.5 mmHG and 16.42 mmHg, respectively. The subgroup analysis did not reveal any significant effect on the development of the blood pressure. While uncontrolled at baseline, 51.4 % of the patients were classified as controlled under the combination therapy after 4 months. The registry supports the medically well tolerated combination therapy for hypertensive patients with a meaningful effect in blood pressure reduction and further 50 % higher proportion of controlled patients.

Keywords: Hypertension, combination, physician’s preference

List of Abbreviation

ESH, European Society of Hypertension; ESC, European Society of Cardiology; ARB, Angiotensin Receptor Blockers; HCTZ, Hydrochlorothiazide; SFDA, Saudi Food and Drug Administration; PV, Pharmacovigilance; CRF, Case Report Form; CI, Confidence Interval; BMI, Body Maß Index

Cite this Reference:

AL Shamiri MQ (2016). An Observational Study to evaluate the behavior of physicians focusing on the preference patterns  of ARB/HCTZ combinations containing high  dose (25 mg) diuretic for the treatment of hypertension in Saudi Arabia. Interlink Continental J. Med. Med. Sci. 2(4): 032-038.


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