Angiotensin II antagonists for hypertension: Are there differences in efficacy?

Angiotensin II antagonists for hypertension: Are there differences in efficacy?

Autor Conlin, P. R. Google Scholar
Spence, J. D. Google Scholar
Williams, B. Google Scholar
Ribeiro, A. B. Google Scholar
Saito, I Google Scholar
Benedict, C. Google Scholar
Bunt, AMG Google Scholar
Instituição Brigham & Womens Hosp
Harvard Univ
Univ Western Ontario
Univ Leicester
Universidade Federal de São Paulo (UNIFESP)
Keio Univ
Univ Texas
Merck & Co Inc
Resumo We compared the antihypertensive efficacy of available drugs in the new angiotensin-II-antagonist (AIIA) class. the antihypertensive efficacy of losartan, valsartan, irbesartan, and candesartan was evaluated from randomized controlled trials (RCT) by performing a metaanalysis of 43 published RCT. These trials involved AIIA compared with placebo, other antihypertensive classes, and direct comparisons between AIIA. A weighted-average for diastolic and systolic blood pressure reduction with AIIA monotherapy, dose titration, and with addition of low-dose hydrochlorothiazide (HCTZ) were calculated. Weighted-average responder rates were also determined. the metaanalysis assessed a total of 11,281 patients. the absolute weighted-average reductions in diastolic (8.2 to 8.9 mm Hg) and systolic (10.4 to 11.8 mm Hg) blood pressure reductions (not placebo-corrected) for AIIA monotherapy were comparable for all AIIA. Responder rates for AIIA monotherapy were 48% to 55%. Dose titration resulted in slightly greater blood pressure reduction and an increase in responder rates to 53% to 63%. AIIA/hydrochlorothiazide combinations produced substantially greater reduction in systolic (16.1 to 20.6 mm Hg) and diastolic (9.9 to 13.6 mm Hg) blood pressure reductions than AIIA monotherapy and responder rates for AIIA/HCTZ combinations were 56% to 70%. This comprehensive analysis shows comparable antihypertensive efficacy within the AIIA class, a near-flat AIIA-dose response when titrating from starting to maximum recommended dose, and substantial potentiation of the antihypertensive effect with addition of HCTZ. (C) 2000 American Journal of Hypertension, Ltd.
Assunto hypertension
randomized controlled trials
efficacy
review
angiotensin-II-antagonists
Idioma Inglês
Data 2000-04-01
Publicado em American Journal of Hypertension. New York: Elsevier B.V., v. 13, n. 4, p. 418-426, 2000.
ISSN 0895-7061 (Sherpa/Romeo, fator de impacto)
Editor Elsevier B.V.
Extensão 418-426
Fonte http://dx.doi.org/10.1016/S0895-7061(99)00237-X
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000086954400016
URI http://repositorio.unifesp.br/handle/11600/26284

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