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Olmesartan compared with other angiotensin II receptor antagonists: head-to-head trials.
Clin Ther. 2004; 26 Suppl A:A33-7.CT

Abstract

BACKGROUND

Drugs that block the renin-angiotensin system represent one of the most significant therapeutic interventions available for the treatment of hypertension. The angiotensin II receptor antagonists (AIIRAs), also known as sartans, are one such class of drugs that block the effects of angiotensin II by antagonizing the angiotensin II type 1 receptor. Olmesartan is the newest member of this class.

OBJECTIVE

The present article reviews 3 head-to-head trials directly comparing the antihypertensive efficacy of olmesartan with that of 4 other AIIRAs, at recommended maintenance doses, already in clinical use for the treatment of hypertension.

RESULTS

In the first study, olmesartan 10 mg/d was compared with losartan 50 mg/d in 316 patients with mild to moderate hypertension (mean baseline diastolic blood pressure [DBP], 95-114 mm Hg). Dosage was doubled at week 4 and hydrochlorothiazide was added at week 12 if blood pressure response was inadequate. Olmesartan was significantly more effective than losartan with respect to the reduction in blood pressure at weeks 2, 4, and 12, and to the responder rate at weeks 2 and 4 (with the starting dose of the respective drug). In a second study, olmesartan 20 mg/d was shown to be significantly more effective than losartan 50 mg/d, valsartan 80 mg/d, and irbesartan 150 mg/d in 588 patients with mild to moderate hypertension (mean sitting baseline DBP, 100-115 mm Hg) (P < or = 0.05). At week 2, the reduction in blood pressure observed with olmesartan was significantly greater than that of the comparator treatments (P < or = 0.05). The superiority of olmesartan was maintained at week 8. The third study involved 643 evaluable patients with moderate to severe hypertension (mean DBP, 100-120 mm Hg; mean systolic blood pressure, >150 mm Hg). Olmesartan 20 mg/d was more effective than candesartan 8 mg/d in lowering 24-hour blood pressure at week 8 (P < or = 0.05). Most of this treatment effect was evident after only 1 or 2 weeks, with greater reductions in blood pressure compared with candesartan.

CONCLUSIONS

These data indicate that, at the doses studied, olmesartan is more effective than other AIIRAs tested at their recommended doses, in terms of reduction of cuff or 24-hour ambulatory blood pressure, in patients with essential hypertension. These differences in blood pressure reduction between these agents may be clinically relevant and have important long-term implications. Additional studies will further define the role of olmesartan in the management of cardiovascular diseases, such as atherosclerosis.

Authors+Show Affiliations

Department of Hypertension and Cardiovascular Research, Medical University Clinic, Bonn, Germany.

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

15291378

Citation

Stumpe, Klaus O.. "Olmesartan Compared With Other Angiotensin II Receptor Antagonists: Head-to-head Trials." Clinical Therapeutics, vol. 26 Suppl A, 2004, pp. A33-7.
Stumpe KO. Olmesartan compared with other angiotensin II receptor antagonists: head-to-head trials. Clin Ther. 2004;26 Suppl A:A33-7.
Stumpe, K. O. (2004). Olmesartan compared with other angiotensin II receptor antagonists: head-to-head trials. Clinical Therapeutics, 26 Suppl A, A33-7.
Stumpe KO. Olmesartan Compared With Other Angiotensin II Receptor Antagonists: Head-to-head Trials. Clin Ther. 2004;26 Suppl A:A33-7. PubMed PMID: 15291378.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Olmesartan compared with other angiotensin II receptor antagonists: head-to-head trials. A1 - Stumpe,Klaus O, PY - 2004/8/5/pubmed PY - 2004/8/31/medline PY - 2004/8/5/entrez SP - A33 EP - 7 JF - Clinical therapeutics JO - Clin Ther VL - 26 Suppl A N2 - BACKGROUND: Drugs that block the renin-angiotensin system represent one of the most significant therapeutic interventions available for the treatment of hypertension. The angiotensin II receptor antagonists (AIIRAs), also known as sartans, are one such class of drugs that block the effects of angiotensin II by antagonizing the angiotensin II type 1 receptor. Olmesartan is the newest member of this class. OBJECTIVE: The present article reviews 3 head-to-head trials directly comparing the antihypertensive efficacy of olmesartan with that of 4 other AIIRAs, at recommended maintenance doses, already in clinical use for the treatment of hypertension. RESULTS: In the first study, olmesartan 10 mg/d was compared with losartan 50 mg/d in 316 patients with mild to moderate hypertension (mean baseline diastolic blood pressure [DBP], 95-114 mm Hg). Dosage was doubled at week 4 and hydrochlorothiazide was added at week 12 if blood pressure response was inadequate. Olmesartan was significantly more effective than losartan with respect to the reduction in blood pressure at weeks 2, 4, and 12, and to the responder rate at weeks 2 and 4 (with the starting dose of the respective drug). In a second study, olmesartan 20 mg/d was shown to be significantly more effective than losartan 50 mg/d, valsartan 80 mg/d, and irbesartan 150 mg/d in 588 patients with mild to moderate hypertension (mean sitting baseline DBP, 100-115 mm Hg) (P < or = 0.05). At week 2, the reduction in blood pressure observed with olmesartan was significantly greater than that of the comparator treatments (P < or = 0.05). The superiority of olmesartan was maintained at week 8. The third study involved 643 evaluable patients with moderate to severe hypertension (mean DBP, 100-120 mm Hg; mean systolic blood pressure, >150 mm Hg). Olmesartan 20 mg/d was more effective than candesartan 8 mg/d in lowering 24-hour blood pressure at week 8 (P < or = 0.05). Most of this treatment effect was evident after only 1 or 2 weeks, with greater reductions in blood pressure compared with candesartan. CONCLUSIONS: These data indicate that, at the doses studied, olmesartan is more effective than other AIIRAs tested at their recommended doses, in terms of reduction of cuff or 24-hour ambulatory blood pressure, in patients with essential hypertension. These differences in blood pressure reduction between these agents may be clinically relevant and have important long-term implications. Additional studies will further define the role of olmesartan in the management of cardiovascular diseases, such as atherosclerosis. SN - 0149-2918 UR - https://www.unboundmedicine.com/medline/citation/15291378/Olmesartan_compared_with_other_angiotensin_II_receptor_antagonists:_head_to_head_trials_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(04)90144-0 DB - PRIME DP - Unbound Medicine ER -