{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:32:11Z","timestamp":1791873131461,"version":"4.3.4"},"reference-count":33,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Kidney Blood Press Res"],"abstract":"<jats:p>Introduction: Four different antihypertensive drug classes are equivalently recommended in the previous guidelines for first-line treatment of arterial hypertension (HTN). However, it is unclear, whether one of these drugs is more capable than the others to reach blood pressure (BP) control. We sought to compare response rates and BP control in these 4 classes. Methods: Patients with newly diagnosed mild to moderate HTN on 24-h BP measurements (ABPM) were randomized in a 1:1:1:1 fashion to either perindopril, olmesartan, amlodipine, or hydrochlorothiazide (HCT). ABPM was completed at baseline (BL) and after 4 weeks of half dose (treatment period 1 [TP1]). If BP control was not reached after TP1, drug dose was doubled and another ABPM completed after 4 weeks (treatment period 2 [TP2]). Patients were classified as controlled if 24-h mean BP was &lt;130\/80 mm Hg, awake BP &lt;135\/85 mm Hg, and night BP &lt;120\/70 mm Hg, and as optimal if 24-h mean BP was 115\u2013124\/65\u201374 mm Hg. Results: 88 patients were randomized: 20 (23%) to perindopril, 23 (26%) to olmesartan, 24 (27%) to amlodipine, and 21 (24%) to HCT. Median 24-h mean BP reduction from BL to TP1 was \u221211\/\u22126 mm Hg and from TP1 to TP2 \u22124\/\u22122 mm Hg. The highest BP reduction was reached with olmesartan (\u221215\/\u221210 mm Hg), particularly for diastolic values, the lowest with HCT (\u22128\/\u22121 mm Hg). 27% of patients reached systo-diastolic BP control, with the best control rate with perindopril and olmesartan (40 and 39%), the lowest with HCT (5%), and 21%\/18% reached an optimal treatment goal for systolic\/diastolic 24-h mean values, respectively, after TP1. Three additional participants (4%) reached BP control after TP2. Conclusion: Initial antihypertensive monotherapy failed in most patients (73% uncontrolled, 21%\/18% reached optimal treatment goal at TP1) even in low-risk patients, with efficacy varying by drug class (inhibitors of the renin-angiotensin-aldosterone system best, HCT least). These findings support guideline-recommended combination therapy. <\/jats:p>","DOI":"10.1159\/000545908","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T16:01:30Z","timestamp":1745337690000},"page":"325-340","source":"Crossref","is-referenced-by-count":4,"title":["Monotherapy Blood Pressure Response and Control Rates in Treatment-Na\u00efve Patients with Arterial Hypertension: A Randomized Comparison of Four Different Antihypertensive Drug Classes"],"prefix":"10.1159","volume":"50","author":[{"given":"Annina Salome","family":"Vischer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Bertsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Van der 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