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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.
Clin Exp Hypertens. 2005 Aug; 27(6):477-89.CE

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 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.

Authors+Show Affiliations

Department of Clinical Pharmacology and Therapeutics, Tohoku University School of Pharmaceutical Science and Medicine, Sendai, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16081340

Citation

Nishimura, Takuya, et al. "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." Clinical and Experimental Hypertension (New York, N.Y. : 1993), vol. 27, no. 6, 2005, pp. 477-89.
Nishimura T, Hashimoto J, Ohkubo T, et al. 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. Clin Exp Hypertens. 2005;27(6):477-89.
Nishimura, T., Hashimoto, J., Ohkubo, T., Kikuya, M., Metoki, H., Asayama, K., Totsune, K., & Imai, Y. (2005). 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. Clinical and Experimental Hypertension (New York, N.Y. : 1993), 27(6), 477-89.
Nishimura T, et al. 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. Clin Exp Hypertens. 2005;27(6):477-89. PubMed PMID: 16081340.
* Article titles in AMA citation format should be in sentence-case
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, PY - 2005/8/6/pubmed PY - 2005/10/21/medline PY - 2005/8/6/entrez SP - 477 EP - 89 JF - Clinical and experimental hypertension (New York, N.Y. : 1993) JO - Clin Exp Hypertens VL - 27 IS - 6 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. SN - 1064-1963 UR - https://www.unboundmedicine.com/medline/citation/16081340/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_ L2 - https://www.tandfonline.com/doi/full/10.1081/CEH-200067668 DB - PRIME DP - Unbound Medicine ER -