This 16-week trial investigated the efficacy and safety of single-pill 
valsartan/hydrochlorothiazide (HCTZ) vs. the individual components in patients 
70 years and older with systolic hypertension. Patients were randomized to 
valsartan/HCTZ 160/12.5 mg (n=128), HCTZ 12.5 mg (n=128), or valsartan 160 mg 
(n=128) for 4 weeks. Patients whose blood pressure (BP) was ≥140/90 mm Hg at 
weeks 4, 8, or 12 were up-titrated to a maximum of valsartan/HCTZ 320/25 mg. 
Week 4 systolic BP reduction (primary efficacy outcome) was greater with 
valsartan/HCTZ than valsartan (-17.3 mm Hg vs. -8.6 mm Hg, P <.0001) but only 
marginally greater than HCTZ (-13.6 mm Hg, P =.096). Median time to BP control 
was shorter with valsartan/HCTZ (4 weeks) vs HCTZ (8 weeks, P<.05) or valsartan 
(12 weeks, P<.0001). Thiazide monotherapy was more effective than angiotensin 
receptor blocker monotherapy (by about 5 mm Hg), but greater antihypertensive 
efficacy was achieved by initiating treatment with combination valsartan/HCTZ in 
the elderly.