Efficacy of Valsartan-HCTZ in hypertension: a cohort study exploring age as a key determinant

BACKGROUND: Hypertension is a major global public health challenge, and effective management of antihypertensive treatment response is crucial. This study aimed to analyze the demographic, clinical, and lifestyle factors influencing treatment response in hypertensive patients receiving Valsartan monotherapy or Valsartan/Hydrochlorothiazide (HCTZ) combination therapy. METHODS: This prospective cohort study included 354 adult patients with hypertension who were on stable antihypertensive therapy for at least 6 months prior to enrollment and were initiated on or switched to Valsartan monotherapy (80 mg) or Valsartan/HCTZ combination therapy (80/12.5 mg or 160/12.5 mg) based on clinical indication. Baseline blood pressure inclusion criteria were 140-179 mmHg systolic and/or 90-109 mmHg diastolic. Demographic, clinical, and lifestyle data were collected. The primary outcome was achievement of target blood pressure (< 140/90 mmHg) after 3 weeks of treatment; the secondary outcome was reduction in systolic (SBP) and diastolic (DBP) blood pressure. Statistical analysis included repeated measures ANOVA, multivariable logistic regression, and post-hoc comparisons with Bonferroni correction. RESULTS: The sample consisted of 58.0% females and 42.0% males. Baseline mean SBP was 157.50 ± 17.23 mmHg and DBP was 103.23 ± 10.17 mmHg. After three weeks of treatment, mean SBP decreased to 131.44 ± 20.40 mmHg and mean DBP to 85.08 ± 12.54 mmHg (p < 0.001). Target BP achievement at Week 3 was 82.6% for Valsartan 80 mg, 70.5% for Valsartan/HCTZ 80/12.5 mg, and 56.4% for Valsartan/HCTZ 160/12.5 mg. These unadjusted rates reflect baseline differences in hypertension severity and comorbidity burden rather than differential regimen efficacy. Younger age, shorter hypertension duration, and absence of diabetes were independently associated with better treatment response in multivariable analysis. CONCLUSION: Younger age and shorter disease duration are key predictors of successful initial blood pressure control with Valsartan-based therapy in this short-term assessment. Longer-term studies are needed to confirm whether these early predictors translate to sustained blood pressure control and reduced cardiovascular events. Treatment should be individualized based on patient age, comorbidity profile, and duration of hypertension, with dose adjustment as needed to achieve optimal outcomes.