Titre du document / Document title

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

Auteur(s) / Author(s)

NISHIMURA Takuya ⁽¹⁾ ; HASHIMOTO Junichiro ^{(2 3)} ; OHKUBO Takayoshi ^{(2 3)} ; KIKUYA Masahiro ^{(2 3)} ; METOKI Hirohito ⁽¹⁾ ; ASAYAMA Kei ^{(1 3)} ; TOTSUNE Kazuhito ^{(1 3)} ; IMAI Yutaka ^{(1 3)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai, JAPON
⁽²⁾ Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai, JAPON
⁽³⁾ Tohoku University 21st Century Center of Excellent CRESCENDO,, Sendai, JAPON

Résumé / Abstract

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 modem 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.

Revue / Journal Title

Clinical and experimental hypertension   ISSN 1064-1963   CODEN CEHYER 

Source / Source

2005, vol. 27, n^o6, pp. 477-489 [13 page(s) (article)] (27 ref.)

Langue / Language

Anglais

Editeur / Publisher

Taylor & Francis, Colchester, ROYAUME-UNI  (1993) (Revue)

Mots-clés anglais / English Keywords

Aminoacid ; Benzimidazole derivatives ; Tetrazole derivatives ; AT1 angiotensin receptor ; Non peptide compound ; Biphenyl derivatives ; Angiotensin antagonist ; Octapeptide ; Peptide hormone ; Antihypertensive agent ; Pressure measurement ; Blood pressure ; Arterial pressure ; Human ; Telmisartan ; Valsartan ; Candesartan ; Losartan ; Angiotensin II ; Duration of action ; Hypertension ; Cardiovascular disease ;

Mots-clés français / French Keywords

Valine dérivé ; Aminoacide ; Benzimidazole dérivé ; Tétrazole dérivé ; Récepteur angiotensine AT1 ; Composé non peptide ; Biphényle dérivé ; Antagoniste angiotensine ; Octapeptide ; Hormone peptide ; Antihypertenseur ; Mesure pression ; Pression sanguine ; Pression artérielle ; Homme ; Telmisartan ; Valsartan ; Candésartan ; Losartan ; Angiotensine II ; Durée action ; Hypertension artérielle ; Appareil circulatoire pathologie ;

Mots-clés espagnols / Spanish Keywords

Aminoácido ; Benzimidazol derivado ; Tetrazol derivado ; Receptor angiotensina AT1 ; Compuesto no péptido ; Bifenilo derivado ; Antagonista angiotensina ; Octapéptido ; Hormona péptido ; Antihipertensivo ; Medida presión ; Presión sanguínea ; Presión arterial ; Hombre ; Telmisartán ; Valsartán ; Candesartán ; Losartán ; Angiotensina II ; Duración acción ; Hipertensión arterial ; Aparato circulatorio patología ;

Mots-clés d'auteur / Author Keywords

angiotensin II receptor blocker ; blood pressure ; duration of action ; home measurements ; hypertension ; M/E ratio ;

Localisation / Location

INIST-CNRS, Cote INIST : 18049 A, 35400013241022.0030