A randomised, double-blind comparison of the angiotensin II receptor antagonist, irbesartan, with the full dose range of enalapril for the treatment of mild-to-moderate hypertension

Mimran, A; Ruilope, Luís M.; Kerwin, Linda; Nys, Marleen; Owens, D. Alfred; Kassler‐Taub, Kenneth; Osbakken, Mary D.

doi:10.1038/sj.jhh.1000591

Cited by 86 publications

(45 citation statements)

References 18 publications

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“…Patients who were initially prescribed irbesartan were also less likely to switch therapy, require add-on therapy, or discontinue therapy. These findings are in accord with clinical trials that have demonstrated that irbesartan has equal efficacy but better tolerability compared with other antihypertensive classes, [17][18][19][20][21][22] and greater efficacy compared with the leading AIIRA agents, losartan and valsartan. 23,24,28 Furthermore, increasing the dosage of irbesartan leads on average to an increased blood pressure reduction.…”

Section: Discussionsupporting

confidence: 80%

“…The AIIRA class holds great promise, as this class has shown efficacy similar to that of older classes of antihypertensive agents while offering placebo-level tolerability. [16][17][18][19][20][21] The present cohort study was undertaken to assess the differences in persistence among all major classes of antihypertensive agents when compared with the AIIRA irbesartan. Comparative clinical trial data show that irbesartan is associated with significantly greater antihypertensive efficacy compared with the two AIIRAs losartan 22,23 and valsartan.…”

Section: Introductionmentioning

confidence: 99%

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A population-based European cohort study of persistence in newly diagnosed hypertensive patients

2002

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This study assessed the percentage of patients after 1 year who persisted on initially prescribed antihypertensive therapy. Medical records of 2416 patients with newly diagnosed hypertension who were prescribed initial antihypertensive monotherapy by general practitioners in Germany, France, and the United Kingdom were evaluated. Comparisons were made among the angiotensin II receptor antagonist (AIIRA) irbesartan, all other antihypertensive classes (including AIIRAs other than irbesartan), and the AIIRA losartan. Patients initiated on the AIIRA irbesartan scored highest with a persistence rate of 60.8%, followed by patients who received all other AIIRA agents with a persistence rate

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

A population-based European cohort study of persistence in newly diagnosed hypertensive patients

2002

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“…The evidence for less cough on ACE-II antagonists agrees with studies comparing other ACE-II antagonists with enalapril during a 12-week trial 35,36 and with lisinopril among people with a history of ACE-inhibitor related cough. 18,37 In the present study there were fewer people with coughs than anticipated.…”

Section: Discussionsupporting

confidence: 77%

Comparison of quality of life and cough on eprosartan and enalapril in people with moderate hypertension

et al. 2001

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The objective of this study was to compare quality of life and incidence of dry persistent cough among patients treated with eprosartan and enalapril for mild-moderate hypertension. This was a randomised 26-week doubleblind controlled trial carried out in clinics in nine countries of North America, Europe and South Africa. A total of 529 patients aged 18 and over with diastolic blood pressure between 95 mm Hg and 114 mm Hg were studied. Treatment comprised of eprosartan or enalapril monotherapy for 12 weeks with the option of hydrochlorothiazide addition for the remaining 14 weeks. The primary outcome measures were cough and the Psychological General Wellbeing Index (PGWB) total and subscales (anxiety, self-control, depression, general health, positive wellbeing and vitality). The results

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“…[2][3][4][5][6][7][8][9][10][11][12][13][14][15]21,25,29,35,43,60 The ARBs are effective and relatively safe in the elderly hypertensives, [2][3][4][5][6][7][8][9][10][11][12][13][14][15]42,52,63 and in patients with isolated systolic hypertension. 76 The antihypertensive efficacy of ARBs is enhanced when combined with diuretics, ACE inhibitors, calcium channel blockers, betablockers, or alpha-blockers.…”

Section: Angiotensin Receptor Blockers As Antihypertensive Drugsmentioning

confidence: 99%

Clinical pharmacokinetics of angiotensin II (AT1) receptor blockers in hypertension

2000

J Hum Hypertens

289

215

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Angiotensin II receptor blockers (ARBs) represent a new class of effective and well tolerated orally active antihypertensive agents. Recent clinical trials have shown the added benefits of ARBs in hypertensive patients (reduction in left ventricular hypertrophy, improvement in diastolic function, decrease in ventricular arrhythmias, reduction in microalbuminuria, and improvement in renal function), and cardioprotective effect in patients with heart failure. Several large long-term studies are in progress to assess the beneficial effects of ARBs on cardiac hypertrophy, renal function, and cardiovascular and cerebrovascular morbidity and mortality in hypertensive patients with or without diabetes mellitus, and the value of these drugs in patients with heart disease and diabetic nephropathy.The ARBs specifically block the interaction of angiotensin II at the AT 1 receptor, thereby relaxing smooth muscle, increasing salt and water excretion, reducing plasma volume, and decreasing cellular hypertrophy. These agents exert their blood pressure-lowering effect mainly by reducing peripheral vascular resistance usually without a rise in heart rate. Most of the commercially available ARBs control blood pressure for 24 h after once daily dosing. Sustained efficacy of blood pressure control, without any evidence of tachyphylaxis, has been demonstrated after long-term administration (3 years) of some of the ARBs. The efficacy of ARBs is similar to that of thiazide diuretics, beta-blockers, angiotensin-converting enzyme inhibitors or calcium channel blockers in patients with similar degree of hypertension. Higher daily doses, dietary salt restriction, and concomitant diuretic or ACE inhibitor administration amplify the antihypertensive effect of ARBs. The ARBs have a low incidence of adverse effects (headache, upper respiratory infection, back pain, muscle cramps, fatigue and dizziness), even in the elderly patients. After the approval of losartan, five other ARBs (candesartan cilexetil, eprosartan, irbesartan, telmisartan, and valsartan) and three combinations with hydrochlorothiazide (irbesartan, losartan and valsartan) have been approved as antihypertensive agents, and some 28 compounds are in various stages of development.The ARBs are non-peptide compounds with varied structures; some (candesartan, losartan, irbesartan, and valsartan) have a common tetrazolo-biphenyl structure. Except for irbesartan, all active ARBs have a carboxylic acid group. Candesartan cilexetil is a prodrug, while losartan has a metabolite (EXP3174) which is more active than the parent drug. No other metabolites of ARBs contribute significantly to the antihypertensive effect.Keywords: angiotensin receptor blockers; candesartan; eprosartan; irbesartan; losartan; telmisartan; valsartan; pharmacokinetics After oral administration, the ARBs are rapidly absorbed (time for peak plasma levels ‫؍‬ 0.5-4 h) but they have a wide range of bioavailability (from a low of 13% for eprosartan to a high of 60-80% for irbesartan); food does not influence the bioavaila...

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A randomised, double-blind comparison of the angiotensin II receptor antagonist, irbesartan, with the full dose range of enalapril for the treatment of mild-to-moderate hypertension

Cited by 86 publications

References 18 publications

A population-based European cohort study of persistence in newly diagnosed hypertensive patients

A population-based European cohort study of persistence in newly diagnosed hypertensive patients

Comparison of quality of life and cough on eprosartan and enalapril in people with moderate hypertension

Clinical pharmacokinetics of angiotensin II (AT1) receptor blockers in hypertension

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