20 Similar efficacy has been reported in patients receiving VAL, in combination with AML in the Exforge Efficacy and Control in Treatment of Stage 2 Hypertension (EX-EFFeCTS) NU7441 mouse
study.21 In the EX-EFFeCTS study, 53.4% of obese patients with stage 2 hypertension uptitrated to AML/VAL 10/160 mg/d achieved the SeBP goal of <140/90 mm Hg. The use of ABPM is an important tool to evaluate the efficacy of antihypertensive treatment strategies in patients at risk for cardiovascular events.16,17 In the present study, in patients with diabetes, BP was reduced throughout the 24-hour dosing interval and during the last 6?hours of the dosing period, coinciding with the normal morning BP surge, an event associated with the greatest cardiovascular risk.22 Approximately one quarter of patients uptitrated to AML/OM 10/40?mg/d achieved the recommended SeBP goal of <130/80?mm Hg, a result comparable with the open-label extension of the COACH study where approximately 19% of patients uptitrated to the same dosage achieved this goal.23 The low rate of SeBP goal achievement supports the observation that <a href="http://www.selleckchem.com/products/BKM-120.html
">BKM120 concentration BP control in patients with diabetes may require multiple antihypertensive agents. Indeed, in the open-label extension of COACH, BP goal achievement was enhanced when HCTZ was added Oxygenase
to AML/OM.23 A factorial design study that evaluated the efficacy and tolerability of a triple combination of AML/OM/HCTZ compared with double therapy has recently been published.24 BP control in clinical practice is much worse than that attained in clinical trials. The lack of BP control in the United States has been attributed largely to therapeutic inertia��the failure to manage a chronic condition aggressively enough to bring it under control.25 Fixed-dose combinations are a rational strategy to address patient compliance and clinical inertia,26 particularly given that combination therapy is typically required in obese patients or patients with diabetes who require more stringent recommended BP targets. Excessive pill burden is also likely to reduce compliance to therapy especially in patients with comorbidities. In patients with MS, pharmacologic intervention may be required if lifestyle changes fail to meet therapeutic goals for addressing risk factors such as hypertension, elevated glucose, dyslipidemia, and prothrombotic states. By reducing pill burden and maintaining tolerability, single-pill drug combinations may facilitate treatment of MS. Most obese patients on monotherapy did not achieve their BP goal.