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Evidence supports the rationale of starting antihypertensive treatment with combination drug therapy because of its effectiveness at attaining blood pressure (BP) goals, resulting in reduced adverse outcomes (JW Cardiol Sep 30 2005), and because monotherapy has proven inadequate to control BP in most patients with hypertension (JW Cardiol Jul 30 2004).
In this manufacturer-sponsored, double-blind, parallel-group, international trial, 1254 patients (mean age, 58; 49% women; systolic BP between 150 mm Hg and 180 mm Hg) were randomly assigned (1:1:2) to treatment with 150-mg aliskiren plus placebo, 5-mg amlodipine plus placebo, or 150-mg aliskiren plus 5-mg amlodipine. At week 8, the medication dose was doubled in all groups. From week 16 to we…