Olmesartan/Amlodipine/Hydrochlorothiazide in Obese Participants With Hypertension: A TRINITY Subanalysis

The objective of this prespecified TRINITY study subgroup analysis was to assess the efficacy and safety of triple-combination treatment with olmesartan medoxomil (OM) 40 mg, amlodipine besylate (AML) 10 mg, and hydrochlorothiazide (HCTZ) 25 mg vs the component dual-combination treatments in obese (body mass index [BMI] >= 30 kg/m(2)) and nonobese (BMI <30 kg/m(2)) hypertensive participants. The double-blind treatment period primary end point was the least-squares (LS) mean reduction in seated diastolic BP (SeDBP) at week 12 (end of the double-blind period). Of the 2492 randomized participants, 1555 (62.4%) had BMI >= 30 kg/m(2). Irrespective of BMI, triple-combination treatment resulted in greater LS mean reductions in seated BP (SeBP) (>= 30 kg/m(2), 6.7-10.5/4.5-7.3 mm Hg; <30 kg/m(2), 5.1-8.6/2.5-6.0 mm Hg [P<.005] vs dual-combination treatments for both subgroups) at week 12. Furthermore, triple-combination treatment enabled a greater proportion of participants to reach BP goal vs the dual-combination treatments (>= 30 kg/m(2), 62% vs 31%-46% [P<.0001]; <30 kg/m(2), 69% vs 41%-55% [P<.005]) at week 12. SeBP reduction and goal attainment (>= 30 kg/m(2), 63%; <30 kg/m 2, 67%) was maintained through week 52/early termination. Triple-combination treatment was well tolerated in both BMI subgroups. (C)2013 Wiley Periodicals, Inc.