Fixed-Free HTN Trial
Fixed-Free HTN Trial
Evaluation of the effect of FIXED triple anti-hypertensive therapy with
 losartan-amlodipin-HCTZ vs any free triple combination therapy chosen by the treating
 physician for patients with uncontrolled hypertension
Patients who have uncontrolled hypertension and who require triple therapy will be randomized
 to receive:

 1. Fixed combination containing 3 anti-hypertensive drugs: losartan 100 mg + amlodipin 5 mg
 + hydrocholorothiazide 12.5 mg one tab/day

 2. Or any other therapy decided by the treating physician containing three
 anti-hypertensive agents but supplied as "free" therapy, meaning supplied as 2 or 3
 separate tablets Patients will have a baseline ambulatory blood pressure recording. The
 same recording will be repeated at 2 months of therapy.

 We expect fixed triple combination to be more effective because the drugs used work
 synergistically together and the compliance will be higher
Inclusion Criteria:

 -  Patients already on free triple anti-HTN therapy whether controlled or not Or patients
 on double anti-HTN therapy who are uncontrolled* Or patients on monotherapy and who
 have a BP > 160/100 mm Hg

 -  BP is defined as UNCONTROLLED if > 135/85 at home or > 140/90 in clinic on at
 least 2 occasions

 Exclusion Criteria:

 -  Contra-indication for the use of ARB or ACEI, CCB or hydrochlorothiazide History of
 angina pectoris or myocardial infarction < 3 months old Permanent atrial fibrillation
 Ejection fraction < 40% Patients with hypertension but who are not on any medication
 Patients with hypertension and who are treated with > 3 drugs