Efficacy, tolerability, and quality of life of losartan, alone or with hydrochlorothiazide, versus nifedipine GITS in patients with essential hypertension

Weir, Matthew R.; Elkins, Michelle; Liss, Charles L.; Vrecenak, Arthur; Barr, Eliav; Edelman, Jonathan M.

doi:10.1016/s0149-2918(96)80022-1

Cited by 49 publications

(29 citation statements)

References 10 publications

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“…Mean baseline values of total PGWB were compa-rable with those found in other studies of hypertensives in Europe and the US 19,20,29,39 and the subscale means tallied with those found at baseline in a similar study. 13 The favourable effects of enalapril compared with eprosartan on self-control and total score were seen at study end point but not at monotherapy end point.…”

Section: Discussionsupporting

confidence: 84%

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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Section: Discussionsupporting

confidence: 84%

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

et al. 2001

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“…This assertion is supported by findings of a substudy of LIFE in hypertensive patients with LVH in which losartan was superior to the beta blocker atenolol in reducing the risk of cardiovascular complications of ISH, particularly stroke. Losartan's documented CV outcomes benefits in the ISH cohort of the LIFE study 76 and its excellent tolerability (alone or in combination with HCTZ) compared with other principal classes of antihypertensive agents, as consistently reproduced in different studies and populations, 72,[87][88][89][90] are likely to have important therapeutic ramifications for the management of SBP. A high degree of tolerability is especially important with respect to patients with systolic hypertension since these patients often require more than one antihypertensive agent to attain the target blood pressures.…”

Section: Discussionmentioning

confidence: 87%

“…72 In several clinical trials, losartan has been shown to be better tolerated than many other types of antihypertensive agents, including calcium channel blockers, ACE inhibitors, and beta blockers, particularly with respect to oedema, cough, and fatigue. [87][88][89][90] In an analysis of 2900 hypertensive patients enrolled in double-blind trials, losartan alone or losartan in combination with HCTZ was well tolerated, with a similar percentage of patients in losartan-treated and placebo-treated patients reporting clinical adverse experiences. 72 Similarly, in patients with ISH, the tolerability of losartan was also found to be similar to placebo and superior to amlodipine or atenolol.…”

Section: Tolerability and Compliancementioning

confidence: 99%

Treatment of systolic hypertension: spotlight on recent studies with angiotensin II antagonists

Volpe

2004

J Hum Hypertens

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Systolic blood pressure has a continuous, graded, strong, independent, and aetiologically significant relationship to mortality from coronary heart disease, stroke, and all cardiovascular diseases, as well as to all-cause mortality and life expectancy. Angiotensin II (AII) may be intimately involved in the pathogenesis of systolic hypertension through multiple mechanisms, including decreasing the elastin content and increasing the collagen content of the arterial wall, thickening and fibrotic remodelling of the vascular intima, and proliferating smooth muscle cells in the arterial wall, resulting in increased thickness, stiffening, and partial loss of contractility. AII antagonists may therefore offer hitherto unrecognized benefits ( independent of blood pressure) on age-related vascular damage and provide particular benefits in patients with systolic hypertension. Recent evidence has demonstrated that losartan offers cardiovascular outcomes benefits in isolated systolic hypertension ( ISH) associated with an excellent tolerability profile. This, in patients with ISH, AII antagonists more facilitate systolic BP control, providing cardiovascular protection and offering an excellent risk-benefit profile

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“…4 Clinical trials have shown that administration of LOS alone lowers blood pressure, and is well tolerated in individuals with hypertension. [5][6][7][8] Furthermore, LOS was found to have beneficial effects on renal and cardiovascular outcomes independent of its antihypertensive function. 9,10 Thiazide diuretics such as hydrochlorothiazide (HCTZ) have also been used for the treatment of hypertension and affect renal tubular mechanisms of electrolyte reabsorption, directly increasing the excretion of Na + and Cl À .…”

Section: Introductionmentioning

confidence: 99%

Mechanism underlying the efficacy of combination therapy with losartan and hydrochlorothiazide in rats with salt-sensitive hypertension

et al. 2011

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Although thiazide diuretics are commonly used to supplement angiotensin receptor blockers for treatment of hypertension, the mechanism underlying the therapeutic effects of this drug combination remains unclear. We investigated the antihypertensive and cardioprotective effects of combination therapy with losartan (LOS) and hydrochlorothiazide (HCTZ), in comparison with those of either drug alone, in Dahl salt-sensitive hypertensive rats. Rats fed a high-salt diet from 6 weeks of age were treated with LOS, HCTZ, both drugs (COMB) and vehicle from 6 to 11 weeks. The salt-induced increase in systolic blood pressure was attenuated moderately by LOS and to a greater extent by HCTZ and COMB. Left ventricular (LV) hypertrophy and fibrosis, diastolic dysfunction, as well as angiotensin-converting enzyme and angiotensin II type 1A (AT 1A ) receptor gene expression were attenuated similarly by LOS and HCTZ and more so by COMB. LOS downregulated expression of the AT 1A receptor gene, without affecting that of the AT 2 receptor gene, in the aorta. In contrast, neither HCTZ nor COMB affected aortic expression of the AT 1A receptor gene, but both markedly upregulated that of the AT 2 receptor gene. The salt-induced decrease in the plasma concentration of nitric oxide metabolites was attenuated substantially by LOS and abolished by both HCTZ and COMB. In conclusion, the combination of LOS and HCTZ attenuated hypertension, as well as LV remodeling and diastolic dysfunction, more effectively than did LOS or HCTZ alone in rats with salt-sensitive hypertension. Modulation of the cardiac and vascular renin-angiotensin system may have contributed to these beneficial effects of the drug combination.

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Efficacy, tolerability, and quality of life of losartan, alone or with hydrochlorothiazide, versus nifedipine GITS in patients with essential hypertension

Cited by 49 publications

References 10 publications

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

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

Treatment of systolic hypertension: spotlight on recent studies with angiotensin II antagonists

Mechanism underlying the efficacy of combination therapy with losartan and hydrochlorothiazide in rats with salt-sensitive hypertension

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