Document Detail


Comparative efficacy of olmesartan, losartan, valsartan, and irbesartan in the control of essential hypertension.
MedLine Citation:
PMID:  11588406     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a multicenter, randomized, double-blind trial, the authors compared the antihypertensive efficacy of once-daily treatment with the new angiotensin II type 1 receptor blocker (ARB) olmesartan (20 mg) with recommended starting doses of losartan (50 mg), valsartan (80 mg), and irbesartan (150 mg) in 588 patients with a cuff diastolic blood pressure (DBP) of greater than or equal to 100 and less than or equal to 115 mm Hg and a mean daytime DBP of greater than or equal to 90 mm Hg and less than 120 mm Hg, as measured by ambulatory blood pressure monitoring. Cuff and ambulatory blood pressures were monitored at baseline and after 8 weeks of treatment. All groups were predominantly white and approximately 62% male, and their mean age was approximately 52 years. In all groups, mean baseline DBP and systolic blood pressure (SBP) were approximately 104 and 157 mm Hg, respectively. The reduction of sitting cuff DBP with olmesartan (11.5 mm Hg), the primary efficacy variable of this study, was significantly greater than with losartan, valsartan, and irbesartan (8.2, 7.9, and 9.9 mm Hg, respectively). Reductions of cuff SBP with the four ARBs ranged from 8.4-11.3 mm Hg and were not significantly different. The reduction in mean 24-hour DBP with olmesartan (8.5 mm Hg) was significantly greater than reductions with losartan and valsartan (6.2 and 5.6 mm Hg, respectively) and showed a trend toward significance when compared to the reduction in DBP with irbesartan (7.4 mm Hg; p=0.087). The reduction in mean 24-hour SBP with olmesartan (12.5 mm Hg) was significantly greater than the reductions with losartan and valsartan (9.0 and 8.1 mm Hg, respectively) and equivalent to the reduction with irbesartan (11.3 mm Hg). All drugs were well tolerated. The authors conclude that olmesartan, at its starting dose, is more effective than the starting doses of the other ARBs tested in reducing cuff DBP in patients with essential hypertension.
Authors:
S Oparil; D Williams; S G Chrysant; T C Marbury; J Neutel
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of clinical hypertension (Greenwich, Conn.)     Volume:  3     ISSN:  1524-6175     ISO Abbreviation:  J Clin Hypertens (Greenwich)     Publication Date:    2001 Sep-Oct
Date Detail:
Created Date:  2001-10-05     Completed Date:  2001-12-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100888554     Medline TA:  J Clin Hypertens (Greenwich)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  283-91, 318     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Disease, University of Alabama, Birmingham, AL 35294, USA. soparil@uab.edu
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Antihypertensive Agents / adverse effects,  therapeutic use*
Biphenyl Compounds / therapeutic use
Chi-Square Distribution
Double-Blind Method
Female
Humans
Hypertension / drug therapy*
Losartan / therapeutic use
Male
Middle Aged
Tetrazoles / therapeutic use
Valine / analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Biphenyl Compounds; 0/Tetrazoles; 114798-26-4/Losartan; 137862-53-4/valsartan; 138402-11-6/irbesartan; 7004-03-7/Valine
Comments/Corrections
Erratum In:
J Clin Hypertens (Greenwich) 2001 Nov-Dec;3(6):395

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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