American Journal of Clinical Medicine Research
ISSN (Print): 2328-4005 ISSN (Online): 2328-403X Website: Editor-in-chief: Dario Galante
Open Access
Journal Browser
American Journal of Clinical Medicine Research. 2018, 6(2), 41-47
DOI: 10.12691/ajcmr-6-2-4
Open AccessCase Report

The Effect of Exforge-HCT on Blood Pressure Control in Omani Hypertensive Patients Attending Sultan Qaboos University Hospital

Ali AlSharqi1, , Halima Aal Homouda1, Tariq Al-Saadi2 and Khamis Al Hashmi3

1Medical Student, Sultan Qaboos University, Muscat, Oman

2Neurosurgical Resident, Montreal Neurological Institute and Hospital - McGill University, Montreal, Canada

3Department of Physiology & Clinical Physiology, Sultan Qaboos University, Muscat, Oman

Pub. Date: July 03, 2018

Cite this paper:
Ali AlSharqi, Halima Aal Homouda, Tariq Al-Saadi and Khamis Al Hashmi. The Effect of Exforge-HCT on Blood Pressure Control in Omani Hypertensive Patients Attending Sultan Qaboos University Hospital. American Journal of Clinical Medicine Research. 2018; 6(2):41-47. doi: 10.12691/ajcmr-6-2-4


Background: Hypertension is worldwide health burden. The major concern about hypertension is that it is usually asymptomatic until it causes end organ damages. The management of hypertension usually starts with monotherapy which fails in achieving targeted BP control in many patients. Therefore, they are switched to combination therapy. Fixed combination therapy is proven to be more effective in controlling hypertension than free combination therapy. Exforge-HCT is a fixed combination drug consisting of Amlodipine, Valsartan and Hydrochlorothiazide. Its effectiveness is not known in Omani hypertensive patients. Aim: To evaluate the role of exforge-HCT in control of blood pressure in Omani hypertensive patients attending SQUH and its effectiveness based on gender. Method: This is a retrospective study. Data was gathered using HIS from January 2013 to June 2016. Patients taking Exforge-HCT were screened for eligibility for the study. Blood pressure measurements before and after using Exforge-HCT were recorded. Patients were grouped according to gender, number of co-morbidities and number of medications used before EXFORGE-HCT into two groups; group one: those who were on triple free drug combination therapy and group two: those who were on dual free drugs. P value of less than 0.05 was considered significant. Results: Total number of patients was 115 with female being 57% and male being 42%. The Level of control of hypertension increased from 22% to 33%. Over all Significant reduction in blood pressure was observed, but there was no gender difference in response to Exforge-HCT. There was significant difference in the response to Exforge-HCT between the medication groups but the response according to gender in each group remains the same. Response to Exforge-HCT was the same regardless the number of co-morbidities in both gender. Conclusion: Exforge-HCT showed significant reduction in BP but no gender difference in response. There was significant difference in the response between the two medication groups. However, the response between genders remains the same in each co-morbidity and medication group. Further prospective study is needed to confirm these findings.

Exforge-HCT Hypertension Oman control fixed combination

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1] (2015). WHO | Q&As on hypertension. [online] Available at: [Accessed 18 Feb. 2016].
[2]  Carretero, O. and Oparil, S. (2000). Essential hypertension: part I: definition and etiology. Circulation, 101(3), pp.329-335.
[3]  Schmieder, R. (2010). End organ damage in hypertension. Deutsches Ärzteblatt International, 107(49), p.866.
[4]  Kearney, P., Whelton, M., Reynolds, K., Muntner, P., Whelton, P. and HE, J. (2005). Global burden of hypertension: analysis of worldwide data. The Lancet, 365(9455), pp.217-223.
[5]  Noncommunicable diseases country profiles 2014. (2014). 1st ed. [ebook] Switzerland: WHO, p.141. Available at: [Accessed 13 Mar. 2016].
[6]  Lloyd-Jones, D., Evans, J., Larson, M., O'Donnell, C., Roccella, E. and Levy, D. (2000). Differential Control of Systolic and Diastolic Blood Pressure : Factors Associated With Lack of Blood Pressure Control in the Community. Hypertension, 36(4), pp.594-599.
[7]  Al-Saadi, R. and Al-Busaidi, Z. (2011). Prevalence of uncontrolled hypertension in primary care settings in Al Seeb Wilayat, Oman. SQUMJ, 11(3), pp.349-356.
[8]  Jacob, J., Chopra, S. and Baby, C. (2011). Neuro-endocrine regulation of blood pressure. Indian Journal of Endocrinology and Metabolism, 15(8), p.281.
[9]  Clark, M., Finkel, R., Rey, J. and Whalen, K. (2012). Lippincott's illustrated reviews: pharmacology. 5th ed. Baltimore: Walters Kluwer, pp.231-236, 239.
[10]  Brown, M., Cruickshank, J., Dominiczak, A., MacGregor, G., Poulter, N., Russell, G., Thom, S. and Williams, B. (2003). better blood pressure control: how to combine drugs. J Hum hypertens, 17(2), pp.81-86.
[11]  Pool, J., Glazer, R., Weinberger, M., Alvarado, R., Huang, J. and Graff, A. (2007). Comparison of valsartan/hydrochlorothiazide combination therapy at doses up to 320/25 mg versus monotherapy: A double-blind, placebo-controlled study followed by long-term combination therapy in hypertensive adults. Clin Ther, 29(1), pp.61-73.
[12]  Calhoun, D., Lacourciere, Y., Chiang, Y. and Glazer, R. (2009). Triple antihypertensive therapy with amlodipine, valsartan, and hydrochlorothiazide: a randomized clinical trial. Hypertension, 54(1), pp.32-39.
[13]  Wald, D., Law, M., Morris, J., Bestwick, J. and Wald, N. (2009). Combination Therapy Versus Monotherapy in Reducing Blood Pressure: Meta-analysis on 11,000 Participants from 42 Trials. The American Journal of Medicine, 122(3), pp.290-300.
[14]  Destro, M., Glazer, R., Yen, J. and Crikelair, N. (2010). Triple combination therapy with amlodipine, valsartan, and hydrochlorothiazide vs dual combination therapy with amlodipine and hydrochlorothiazide for stage 2 hypertensive patients. VHRM, 6, pp.821-827.
[15]  Black, H. (2009). Triple fixed-dose combination therapy: back to the past. Hypertension, 54(1), pp.19-22.
[16]  Ferdinand, K. and Nasser, S. (2013). A Review of the Efficacy and Tolerability of Combination Amlodipine/Valsartan in Non-White Patients with Hypertension. American Journal of Cardiovascular Drugs, 13(5), pp.301-313.
[17]  Deeks, E. (2009). amlodipine/valsartan/hydrochlorothiazide. American Journal Cardiovascular Drugs, 9(6), pp.411-418.
[18]  Krzesinski, J. and Cohen, p. (2009). Exforge® (amlodipine/valsartan combination) in hypertension: the evidence of its therapeutic impact. Core Evidence, 4, pp.1-11.
[19]  Trifiro, G. and Spina, E. (2011). Age-related Changes in Pharmacodynamics: Focus on Drugs Acting on Central Nervous and Cardiovascular Systems. Current Drug Metabolism, 12(7), pp.611-620.
[20]  Al-Baghli, N. Al-Turki, K. AL-Ghamdi, A. Al-Zubaier, A. Al-Baghli, F. and Al-Bohlaiqa, N. (2009). Control of hypertension in eastern Saudi Arabia: Results of screening campaign. Journal of Family and Community Medicine, 16(1), pp.19-25.
[21]  Fan, X., Han, Y., Sun, K., Wang, Y., Xin, Y., Bai, Y., Li, W., Yang, T., Song, X., Wang, H., Fu, C., Chen, J., Shi, Y., Zhou, X., Wu, H. and Hui, R. (2008). Sex Differences in Blood Pressure Response to Antihypertensive Therapy in Chinese Patients with Hypertension. Annals of Pharmacotherapy, 42(12), pp.1772-1781.
[22]  Pecherebertschi, A. and Burnier, M. (2004). Female sex hormones, salt, and blood pressure regulation. American Journal of Hypertension, 17(10), pp.994-1001.
[23]  Sarkar, C., Dodhia, H., Crompton, J., Schofield, P., White, P., Millett, C. and Ashworth, M. (2015). Hypertension: a cross-sectional study of the role of multimorbidity in blood pressure control. BMC Family Practice, 16(1).
[24]  Saadat, Z., Nikdoust, F., Aerab-Sheibani, H., Bahremand, M., Shobeiri, E., Saadat, H., Moharramzad, Y. and Morisky, D. (2015). Adherence to Antihypertensives in Patients With Comorbid Condition. Nephro-Urology Monthly, 7(4).