TY - JOUR
T1 - Efficacy and duration of action of the four selective angiotensin II subtype 1 receptor blockers, losartan, candesartan, valsartan and telmisartan, in patients with essential hypertension determined by home blood pressure measurements
AU - Nishimura, Takuya
AU - Hashimoto, Junichiro
AU - Ohkubo, Takayoshi
AU - Kikuya, Masahiro
AU - Metoki, Hirohito
AU - Asayama, Kei
AU - Totsune, Kazuhito
AU - Imai, Yutaka
N1 - Funding Information:
This work was supported by Grants for Scientific Research (12877163, 13470085, 13671095, 15790293) from the Ministry of Education, Culture, Sports, Science and Technology, by Health Science Research Grants on Health Services (13170201, 13072101, H12-Medical Care-002) and H15Gan Yobou-039 from the Ministry of Health, Labor and Welfare, Japan; and by research grants from Junkanki-byo Itaku Kenkyu 11C-5 (1999 and 2000), and the Japan Atherosclerosis Prevention Fund (2000 to 2003), and Uehara Memorial Foundation (2002); and grant from Japan Cardiovascular Research Foundation (2002), the Takeda Medical Research Foundation (2003).
PY - 2005/8
Y1 - 2005/8
N2 - Our objective was to compare the efficacy and duration of action of 4 angiotensin II receptor blockers (ARBs)-losartan (25-100 mg), candesartan (2-12 mg), valsartan (40-80 mg), and telmisartan (10-40 mg)-in patients with essential hypertension using self-measurement of blood pressure at home (home BP) and to examine the differential effect of the four ARBs on home pulse pressure (home PP). After a 2-week run-in period, each of the 4 ARBs was assigned to subjects who were diagnosed as having hypertension on the basis of home BP and who were over 30 years old. The subjects were asked to take the ARB once daily in the morning and to measure home BP once in the evening and in the morning. We compared the efficacy of each ARB on home BP and home PP and assessed the duration of the BP-lowering effect using the morning effect versus evening effect ratio (M/E ratio). The antihypertensive effects of telmisartan on home systolic BP (SBP) both in the evening and in the morning and on home diastolic BP (DBP) in the morning were significantly greater than those of losartan. The effect of each ARB on home BP in the morning and in the evening was expressed as a ratio (M/E ratio). The M/E ratios of SBP/DBP in patients treated with losartan, candesartan, valsartan, and telmisartan were 0.49/0.16, 0.69/1.01, 0.82/0.88, and 0.88/0.88, respectively. The home PP-lowering effect was greater for valsartan and telmisartan than for losartan and candesartan in the morning. Among the 4 ARBs, the duration of the BP-lowering effect of losartan did not persist throughout 24 hr. The effects of the other 3 ARBs, in particular telmisartan, persisted over 24 hr when they were administered once daily in the morning. In addition, the duration of the PP-lowering effect was similar to that of the BP-lowering effect. Such long-acting property of several ARBs is essential for the modern antihypertensive treatment, and home BP measurements are useful for determining the duration of action of antihypertensive drugs. Losartan, 25 mg a day, which is usually used as an initial dose in Japan, is apparently insufficient to obtain adequate antihypertensive effect and sufficient duration of action.
AB - Our objective was to compare the efficacy and duration of action of 4 angiotensin II receptor blockers (ARBs)-losartan (25-100 mg), candesartan (2-12 mg), valsartan (40-80 mg), and telmisartan (10-40 mg)-in patients with essential hypertension using self-measurement of blood pressure at home (home BP) and to examine the differential effect of the four ARBs on home pulse pressure (home PP). After a 2-week run-in period, each of the 4 ARBs was assigned to subjects who were diagnosed as having hypertension on the basis of home BP and who were over 30 years old. The subjects were asked to take the ARB once daily in the morning and to measure home BP once in the evening and in the morning. We compared the efficacy of each ARB on home BP and home PP and assessed the duration of the BP-lowering effect using the morning effect versus evening effect ratio (M/E ratio). The antihypertensive effects of telmisartan on home systolic BP (SBP) both in the evening and in the morning and on home diastolic BP (DBP) in the morning were significantly greater than those of losartan. The effect of each ARB on home BP in the morning and in the evening was expressed as a ratio (M/E ratio). The M/E ratios of SBP/DBP in patients treated with losartan, candesartan, valsartan, and telmisartan were 0.49/0.16, 0.69/1.01, 0.82/0.88, and 0.88/0.88, respectively. The home PP-lowering effect was greater for valsartan and telmisartan than for losartan and candesartan in the morning. Among the 4 ARBs, the duration of the BP-lowering effect of losartan did not persist throughout 24 hr. The effects of the other 3 ARBs, in particular telmisartan, persisted over 24 hr when they were administered once daily in the morning. In addition, the duration of the PP-lowering effect was similar to that of the BP-lowering effect. Such long-acting property of several ARBs is essential for the modern antihypertensive treatment, and home BP measurements are useful for determining the duration of action of antihypertensive drugs. Losartan, 25 mg a day, which is usually used as an initial dose in Japan, is apparently insufficient to obtain adequate antihypertensive effect and sufficient duration of action.
KW - Angiotensin II receptor blocker
KW - Blood pressure
KW - Duration of action
KW - Home measurements
KW - Hypertension
KW - M/E ratio
UR - http://www.scopus.com/inward/record.url?scp=23844494098&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=23844494098&partnerID=8YFLogxK
U2 - 10.1081/CEH-200067668
DO - 10.1081/CEH-200067668
M3 - Article
C2 - 16081340
AN - SCOPUS:23844494098
SN - 1064-1963
VL - 27
SP - 477
EP - 489
JO - Clinical and Experimental Hypertension
JF - Clinical and Experimental Hypertension
IS - 6
ER -