Telmisartan/hydrochlorothiazide versus valsartan/hydrochlorothiazide in obese hypertensive with type 2 diabetes: the SMOOTH study

Sharma, Arya M.; Davidson, Jaime; Koval, Stephen; Lacourcière, Yves
January 2007
Cardiovascular Diabetology;2007, Vol. 6, p28
Academic Journal
Background: The Study of Micardis (telmisartan) in Overweight/Obese patients with Type 2 diabetes and Hypertension (SMOOTH) compared hydrochlorothiazide (HCTZ) plus telmisartan or valsartan fixed-dose combination therapies on early morning blood pressure (BP), using ambulatory BP monitoring (ABPM). Methods: SMOOTH was a prospective, randomized, open-label, blinded-endpoint, multicentre trial. After a 2- to 4-week, single-blind, placebo run-in period, patients received once-daily telmisartan 80 mg or valsartan 160 mg for 4 weeks, with add-on HCTZ 12.5 mg for 6 weeks (T/HCTZ or V/HCTZ, respectively). At baseline and week 10, ambulatory blood pressure (ABP) was measured every 20 min and hourly means were calculated. The primary endpoint was change from baseline in mean ambulatory systolic and diastolic blood pressure (SBP; DBP) during the last 6 hours of the 24-hour dosing interval. Results: In total, 840 patients were randomized. At week 10, T/HCTZ provided significantly greater reductions versus V/HCTZ in the last 6 hours mean ABP (differences in favour of T/HCTZ: SBP 3.9 mm Hg, p < 0.0001; DBP 2.0 mm Hg, p = 0.0007). T/HCTZ also produced significantly greater reductions than V/HCTZ in 24-hour mean ABP (differences in favour of T/HCTZ: SBP 3.0 mm Hg, p = 0.0002; DBP 1.6 mm Hg, p = 0.0006) and during the morning, daytime and night-time periods (p < 0.003). Both treatments were well tolerated. Conclusion: In high-risk, overweight/obese patients with hypertension and type 2 diabetes, T/HCTZ provides significantly greater BP lowering versus V/HCTZ throughout the 24-hour dosing interval, particularly during the hazardous early morning hours.


Related Articles

  • Telmisartan in daily clinical practice: Factors affecting efficacy in treatment of primary arterial hypertension. Bergovac, M.; Knežević, A.; Plavec, S.; Trkulja, V. // Journal of Postgraduate Medicine;Jan-Mar2009, Vol. 55 Issue 1, p27 

    Background: Telmisartan provides effective treatment of hypertension in a broad spectrum of patients. Aims: To evaluate factors affecting the efficacy of telmisartan in daily clinical practice. Setting and Design: Prospective practice-based 12-week uncontrolled cohort study. Materials and...

  • Multiple Normal Deliveries in a Woman with Severe Portal Hypertension Due to Congenital Hepatic Fibrosis: The Importance of Preserved Hepatocellular Function. Mindikoglu, Ayse L.; Regev, Arie; O'Sullivan, Mary J.; Schiff, Eugene R. // American Journal of Gastroenterology;Oct2005, Vol. 100 Issue 10, p2359 

    We report a 26-year-old woman with congenital hepatic fibrosis (CHFib), adult polycystic kidney disease, type II diabetes mellitus, and von Willebrand disease, who despite persistent advice to the contrary because of severe portal hypertension, had 5 pregnancies delivering 6 healthy infants over...

  • C. Hypertension and Systemic Disease.  // Kidney;May/Jun2005, Vol. 14 Issue 3, p121 

    Presents abstracts of several studies on hypertension and systemic disease. "Blood Pressure Drugs Differ in Efficacy in Black Patients," by L. M. Brewster, G. A. van Montfrans and J. Kleijnen, published in the 2004 issue of "Annals of Internal Medicine"; "Possible Serum Marker for Preeclampsia...

  • Control of hypertension in diabetes. Bain, Steve; Samat, Ashish // GP: General Practitioner;8/18/2006, p22 

    The article discusses the effective control of blood pressure (BP) in the patients of diabetes. Researchers say that patients with type-1 diabetes are vulnerable to hypertension. To prevent any emergency, it is advised that BP readings should be taken over three to six months before considering...

  • Blood pressure, antihypertensive treatment and factors associated with good blood pressure control in hypertensive diabetics: the Tarmidas study. de Pablos-Velasco, P.; Gonzalez-Albarran, O.; Estopiñan, V.; Khanbhai, A. // Journal of Human Hypertension;Aug2007, Vol. 21 Issue 8, p664 

    Numerous population studies confirm the high prevalence of hypertension in type II diabetic (DM2) subjects and that intensive antihypertensive treatment is more beneficial to diabetic than to nondiabetic hypertensive subjects, yet not many of these are specific to Spain. To assess the degree of...

  • Identifying causes of secondary hypertension. Smoot, Laura Carter; Smoot, Kenneth E. // Drug Topics;9/15/2008, Vol. 152 Issue 10, p62 

    The article offers information on secondary hypertension. It has an identifiable cause and oftenly associated to certain conditions and medications. The identifiable causes of this disease are renal disorders, endocrine disorders, obstructive uropathy, pregnancy, and stress. The diagnosis of...

  • What Was Normal Blood Pressure Is Now Considered Too High.  // Tufts University Health & Nutrition Letter;Jul2003, Vol. 21 Issue 5, p4 

    Reports on the introduction of the prehypertension category in the blood pressure guidelines of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure in the U.S., as of July 2003. Prevalence of prehypertension in the U.S.; Lifestyle changes...

  • Chapter 1: What is High Blood Pressure? Gregson, Susan R. // High Blood Pressure (Capstone Press);2001, p4 

    This chapter describes high blood pressure. Blood pressure is the force of your blood on the walls of your arteries. When blood pressure stays high for too long, it can damage your blood vessels. There are two numbers used in measuring blood pressure. The first number records systolic pressure,...

  • Here's the lowdown on high blood pressure. Bennett, Lydia // New Hampshire Business Review;4/19/2002, Vol. 24 Issue 8, p9B 

    Discusses how to deal with high blood pressure. Causes of hypertension; Risks associated with hypertension; Details of how to avoid complications.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics