Literature DB >> 8986917

Valsartan, a new angiotensin II antagonist for the treatment of essential hypertension: efficacy and safety compared with placebo and enalapril.

N J Holwerda1, R Fogari, P Angeli, C Porcellati, C Hereng, P Oddou-Stock, R Heath, F Bodin.   

Abstract

OBJECTIVE: To compare the antihypertensive efficacy and systemic tolerability of valsartan, a new angiotensin II receptor antagonist, with placebo and with an angiotensin converting enzyme (ACE) inhibitor, enalapril.
DESIGN: A total of 348 adult outpatients with mild-to-moderate uncomplicated essential hypertension participated in this double-blind, parallel, study. Patients were allocated randomly in a ratio of 2:2:1 to receive 80 mg valsartan once a day, 20 mg enalapril once a day, or placebo for 8 weeks in general practice. Patients were assessed at 4 and 8 weeks of therapy. MAIN OUTCOME MEASURES: The primary efficacy variable was the change from baseline in mean sitting diastolic blood pressure (SDBP) after 8 weeks of therapy. Secondary variables included the change in sitting systolic blood pressure (SSBP) and response rates at 8 weeks.
RESULTS: Valsartan and enalapril produced statistically significant reductions in diastolic and systolic blood pressures compared with placebo. Similar falls were found in both of the active treatment groups with mean changes in SDBP at 8 weeks of -9.5 mmHg for valsartan and -9.4 mmHg for enalapril (-4.5 mmHg for placebo). No significant differences between valsartan and enalapril were found for reductions in SDBP or SSBP. Response rates at 8 weeks were significantly greater for valsartan (54%) and enalapril (58%) than for placebo (20%), with no significant difference between the two active treatments. Both valsartan and enalapril demonstrated a consistent antihypertensive effect over time, with 90% of patients with a response at 4 weeks responding at 8 weeks. Both of the treatments were tolerated well. Although the incidence of coughing was generally low in the study, more cases were reported with enalapril (three) than with valsartan (one) or placebo (none).
CONCLUSIONS: The data show 80 mg valsartan once a day to be as effective as 20 mg enalapril once a day in the treatment of mild-to-moderate hypertension. Valsartan is tolerated well and does not appear to be associated with any increase in the incidence of coughing.

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Year:  1996        PMID: 8986917     DOI: 10.1097/00004872-199609000-00016

Source DB:  PubMed          Journal:  J Hypertens        ISSN: 0263-6352            Impact factor:   4.844


  16 in total

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Review 2.  Valsartan. A review of its pharmacology and therapeutic use in essential hypertension.

Authors:  A Markham; K L Goa
Journal:  Drugs       Date:  1997-08       Impact factor: 9.546

3.  Comparison of enalapril and valsartan in cyclosporine A-induced hypertension and nephrotoxicity in spontaneously hypertensive rats on high-sodium diet.

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4.  Valsartan. Just a second-line antihypertensive drug.

Authors: 
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Review 5.  Therapeutic trials comparing angiotensin converting enzyme inhibitors and angiotensin II receptor blockers.

Authors:  W J Elliott
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6.  Updated meta-analytical approach to the efficacy of antihypertensive drugs in reducing blood pressure.

Authors:  J P Baguet; B Legallicier; P Auquier; S Robitail
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Review 7.  Blood pressure lowering efficacy of angiotensin converting enzyme (ACE) inhibitors for primary hypertension.

Authors:  Balraj S Heran; Michelle My Wong; Inderjit K Heran; James M Wright
Journal:  Cochrane Database Syst Rev       Date:  2008-10-08

8.  Efficacy and tolerability of valsartan in combination with hydrochlorothiazide in essential hypertension.

Authors:  W D Hall; R Montoro; T Littlejohn; A Jain; N Feliciano; H Zheng
Journal:  Clin Drug Investig       Date:  1998       Impact factor: 2.859

9.  Effectiveness and safety of valsartan in children aged 6 to 16 years with hypertension.

Authors:  Thomas Wells; Jeffrey Blumer; Kevin E C Meyers; Jose P R Neto; Rejane Meneses; Mieczysław Litwin; Johan Vande Walle; Susan Solar-Yohay; Victor Shi; Guangyang Han
Journal:  J Clin Hypertens (Greenwich)       Date:  2011-03-18       Impact factor: 3.738

10.  A systematic review and network meta-analysis of the comparative efficacy of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in hypertension.

Authors:  Chrisa Dimou; Christina Antza; Evangelos Akrivos; Ioannis Doundoulakis; Stella Stabouli; Anna Bettina Haidich; Vasilios Kotsis
Journal:  J Hum Hypertens       Date:  2018-12-05       Impact factor: 3.012

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