The efficacy and safety of valsartan compared with placebo in the treatment of patients with essential hypertension

Oparil, Suzanne; Dyke, Stephen H.; Harris, F. Dee; Kief, Jan; James, Deborah; Hester, Allen; Fitzsimmons, Sheila

doi:10.1016/s0149-2918(96)80040-3

Cited by 127 publications

(72 citation statements)

References 17 publications

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“…Eligible patients were randomised into two groups to give a 2:1 ratio of valsartan to atenolol treatment, in order to maximise the data obtained from the valsartan treatment group. Patients received either valsartan 160 mg (a dose which has been shown to be effective and safe in patients with mild to moderate hypertension) 11 or atenolol 100 mg (a dose considered comparable to valsartan 160 mg), as two capsules (2 × valsartan 80 mg or 2 × atenolol 50 mg) to be taken once daily at 8 am. Study drugs were supplied in identical capsules to maintain blinding.…”

Section: Methodsmentioning

confidence: 99%

“…6 Valsartan is a new, orally active, potent and highly selective angiotensin II receptor antagonist 7 which at doses of 80 and 160 mg once daily has been shown to be effective in the treatment of mild to moderate hypertension compared with placebo [8][9][10] and to be safe and well tolerated, lacking the side effects characteristic of the ACE inhibitors. 11 To date all published studies have evaluated the use of valsartan in patients with mild to moderate lol, ؊25.5 mm Hg. There was no statistically significant difference between the treatment groups.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11] The purpose of the current study was to evaluate the efficacy and tolerability of valsartan in the treatment of patients with severe hypertension, and to compare 160 mg valsartan with a reference anti-hypertensive therapy, 100 mg atenolol, both as initial monotherapy and in combination with other antihypertensive agents.…”

Section: Introductionmentioning

confidence: 99%

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Valsartan and atenolol in patients with severe essential hypertension

et al. 1998

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The aim of this study was to evaluate the efficacy and tolerability of valsartan, a new angiotensin II receptor antagonist, versus atenolol in the treatment of severe primary hypertension. A total of 103 adult out-patients were randomised to receive either valsartan 160 mg or atenolol 100 mg once daily for 6 weeks. If necessary, additional blood pressure (BP) control could be provided as add-on therapy. Both valsartan and atenolol decreased mean sitting diastolic BP (DBP) and mean sitting systolic BP (SBP): least squares mean change from baseline in DBP; valsartan, ؊20.0 mm Hg; atenolol, ؊20.4 mm Hg: in SBP; valsartan, ؊30.0 mm Hg; ateno-

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Valsartan and atenolol in patients with severe essential hypertension

et al. 1998

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“…16 This body of clinical evidence compares favourably with clinical experience gained with some other AIIRAs. Losartan and valsartan, for example, display a flat dose-response relationship in their blood pressure-lowering effects, 17,18 while for irbesartan there appears to be a dose-response relationship in patients with mild to moderate hypertension. 19 A meta-analysis of six large, placebocontrolled, randomised studies ( Figure 3) clearly illustrates the dose-response relationship of candesartan cilexetil given in doses from 4 -16 mg once daily.…”

Section: Antihypertensive Efficacy Of Candesartan In Clinical Trialsmentioning

confidence: 99%

Key features of candesartan cilexetil and a comparison with other angiotensin II receptor antagonists

Sever

1999

J Hum Hypertens

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Current research on angiotensin II AT 1 -receptor antagonists (AIIRAs) and selected studies presented at the recent symposium held in Amsterdam, The Netherlands, on 6 June 1998, titled 'Angiotensin II Receptor Antagonists are NOT all the Same' are reviewed. AIIRAs offer a number of potential advantages over alternative antihypertensive agents acting via the renin-angiotensin-aldosterone system. They combine blood pressure-lowering effects at least equivalent to those of angiotensin-converting enzyme (ACE) inhibitors, coupled with placebolike tolerability. Candesartan cilexetil is a novel AIIRA that has demonstrated clinical efficacy superior to losartan, has a sustained duration of action over 24 hours (trough:peak ratio close to 100%) and is well tolerated Keywords: candesartan cilexetil; angiotensin II AT 1 -receptor antagonist; organ protection; review Antihypertensive therapyNon-peptide angiotensin II AT 1 -receptor antagonists (AIIRAs) are a new class of drugs that represent a major advance in therapeutics for the treatment of cardiovascular disease. Members of this new class have been proved effective in the treatment of hypertension and have recently also shown promise for the treatment of heart failure. AIIRAs attenuate the effects of angiotensin II by blocking its action, competitively or non-competitively, at the AT 1 receptor. This receptor subtype mediates the cardiovascular and metabolic activities of angiotensin II. 1 This mode of action contrasts with that of angiotensin-converting enzyme (ACE) inhibitors, which partially inhibit the conversion of angiotensin I to angiotensin II. One of the disadvantages of ACE inhibitors is that angiotensin II is also produced by non-ACE-dependent pathways, notably those involving chymase in the heart and other tissues. 2 The more specific mechanism of action of AIIRAs means that the actions of angiotensin II are completely blocked at the effector site, independently of the route of its production. Moreover, because ACE is identical to the enzyme kininase II, which inhibits bradykinin formation, AIIRAs avoid the bradykinin potentiation induced by ACE inhibitors and the in patients with essential hypertension. Candesartan cilexetil has a rapid onset of action (approximately 80% of total blood pressure reduction within the first 2 weeks) and dose-dependent effects on blood pressure, is comparable in efficacy to a number of classes of antihypertensives, and is effective in combination therapy (eg, with hydrochlorothiazide and amlodipine). This favourable profile may be due in part to the highly selective, tight binding to and slow dissociation of candesartan from the AT 1 receptor. Preliminary studies suggest that candesartan cilexetil also protects end organs (kidney, heart, vasculature, and brain) beyond blood pressure control.

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“…4 However, it is uncertain whether the same is true of all ARBs. Among ARBs, valsartan has been suggested to be effective in lowering the blood pressure in both Whites and Blacks, 7 although Blacks often show low-renin status. Thus, we conducted this study to investigate whether pretreatment PRA levels predicted an ABP response to valsartan in newly diagnosed patients with essential hypertension.…”

mentioning

confidence: 99%