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

dc.contributor.authorConlin, P. R.
dc.contributor.authorSpence, J. D.
dc.contributor.authorWilliams, B.
dc.contributor.authorRibeiro, A. B.
dc.contributor.authorSaito, I
dc.contributor.authorBenedict, C.
dc.contributor.authorBunt, AMG
dc.contributor.institutionBrigham & Womens Hosp
dc.contributor.institutionHarvard Univ
dc.contributor.institutionUniv Western Ontario
dc.contributor.institutionUniv Leicester
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionKeio Univ
dc.contributor.institutionUniv Texas
dc.contributor.institutionMerck & Co Inc
dc.description.abstractWe 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.en
dc.description.affiliationBrigham & Womens Hosp, Endocrinol Hypertens, Boston, MA 02115 USA
dc.description.affiliationHarvard Univ, Sch Med, Boston, MA 02115 USA
dc.description.affiliationUniv Western Ontario, Siebens Drake Robarts Res Inst, London, ON, Canada
dc.description.affiliationUniv Leicester, Inst Cardiovasc Res, Leicester, Leics, England
dc.description.affiliationUNIFESP, EPM, Div Nephrol, São Paulo, Brazil
dc.description.affiliationKeio Univ, Ctr Hlth, Tokyo, Japan
dc.description.affiliationUniv Texas, Sch Med, Houston, TX USA
dc.description.affiliationMerck & Co Inc, Whitehouse Stn, NJ USA
dc.description.affiliationUnifespUNIFESP, EPM, Div Nephrol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.identifier.citationAmerican Journal of Hypertension. New York: Elsevier B.V., v. 13, n. 4, p. 418-426, 2000.
dc.publisherElsevier B.V.
dc.relation.ispartofAmerican Journal of Hypertension
dc.rightsAcesso restrito
dc.subjectrandomized controlled trialsen
dc.titleAngiotensin II antagonists for hypertension: Are there differences in efficacy?en