J Scholze1, M Stapff. 1. Humboldt-University, Charité, Berlin, Germany.
Abstract
AIMS: To evaluate initial blood pressure effects of the angiotensin II antagonist losartan (L) immediately after switching from an ACE inhibitor (captopril, C). METHODS: Two-phase multicentre randomized study in 177 outpatients with mild to moderate essential hypertension. For 6 weeks all patients received 25 mg C twice daily. Then they were randomized double-blind to switch for another 6 weeks to 50 mg L once daily (n=110) or to maintain C (n=55). On the first day of the switch they underwent ambulatory blood pressure measurement (ABPM). RESULTS: Within 12 h of first dose, 31% of patients who switched to L had two consecutive systolic BP readings of 30 mmHg below their individual baseline value compared with 24% of patients who stayed on C. In 3% of patients with L and in 6% of the C patients systolic BP readings less than 100 mmHg were recorded within 12 h of first dose. The differences were not statistically significant. There were no clinical symptoms attributable to initial hypotension. During the 6 weeks double-blind therapy, 9% of L patients experienced at least one adverse event, compared with 16% of patients with C. CONCLUSIONS: In this study the angiotensin II antagonist losartan was effective and generally well tolerated when administered immediately after pretreatment with an ACE inhibitor.
RCT Entities:
AIMS: To evaluate initial blood pressure effects of the angiotensin II antagonist losartan (L) immediately after switching from an ACE inhibitor (captopril, C). METHODS: Two-phase multicentre randomized study in 177 outpatients with mild to moderate essential hypertension. For 6 weeks all patients received 25 mg C twice daily. Then they were randomized double-blind to switch for another 6 weeks to 50 mg L once daily (n=110) or to maintain C (n=55). On the first day of the switch they underwent ambulatory blood pressure measurement (ABPM). RESULTS: Within 12 h of first dose, 31% of patients who switched to L had two consecutive systolic BP readings of 30 mmHg below their individual baseline value compared with 24% of patients who stayed on C. In 3% of patients with L and in 6% of the C patients systolic BP readings less than 100 mmHg were recorded within 12 h of first dose. The differences were not statistically significant. There were no clinical symptoms attributable to initial hypotension. During the 6 weeks double-blind therapy, 9% of L patients experienced at least one adverse event, compared with 16% of patients with C. CONCLUSIONS: In this study the angiotensin II antagonist losartan was effective and generally well tolerated when administered immediately after pretreatment with an ACE inhibitor.
Authors: J C Chan; J A Critchley; J T Lappe; S J Raskin; D Snavely; A I Goldberg; C S Sweet Journal: J Hum Hypertens Date: 1995-09 Impact factor: 3.012