Hypertension affects approximately 26% of the world's adult population and is a 
recognized major risk factor for morbidity and mortality associated with 
cardiovascular, cerebrovascular, and renal diseases. However, despite the 
availability of a range of effective antihypertensive agents and a growing 
awareness of the consequences of high blood pressure (BP), the treatment and 
control of hypertension remains suboptimal. A number of patient subgroups are 
categorized as 'high risk' and may have hypertension that is more difficult to 
treat, including obese individuals, patients with stage 2 hypertension, those 
with type 2 diabetes mellitus (T2DM), patients with coronary artery disease or a 
history of stroke, and Black patients. As the benefits of lowering BP in 
patients with hypertension are unequivocal, particularly in high-risk patients, 
treating high-risk patients with hypertension to BP goals and maintaining 
24-hour BP control is important to help reduce cardiovascular risk and improve 
outcomes. Although the BP goals recommended in current consensus guidelines for 
the management of patients with hypertension are based on cuff BP measurements, 
ambulatory BP monitoring (ABPM) provides a valuable diagnostic tool and allows a 
more accurate assessment of BP levels throughout the 24-hour dosing period. ABPM 
is a better predictor of prognosis than office BP measurement and is also useful 
for assessing whether antihypertensive therapy remains effective in the critical 
last few hours of the dosing period, which usually coincides with the morning BP 
surge associated with arousal and arising. ABPM has been adopted by new 
evidence-based guidelines in the United Kingdom to confirm a suspected diagnosis 
of hypertension, which is an indication of the growing importance of ABPM in the 
management of hypertension. This review provides an overview of the efficacy and 
safety of antihypertensive therapy based on olmesartan 
medoxomil ± hydrochlorothiazide and amlodipine/olmesartan medoxomil in high-risk 
patient populations enrolled in studies that reported ambulatory BP endpoints. 
The studies identified in this review showed that a titrate-to-BP goal strategy 
using olmesartan medoxomil- or amlodipine/olmesartan medoxomil-based 
antihypertensive therapy was an effective and well-tolerated approach for 
maintaining BP control throughout the full 24-hour dosing period in high-risk 
patients with difficult-to-treat hypertension.