Valsartan: long-term efficacy and tolerability compared to lisinopril in elderly patients with essential hypertension.
A total of 501 elderly patients with essential hypertension were randomized to receive valsartan or lisinopril in this one year multi-center, double-blind, parallel group trial. Patients received valsartan 40 mg (n = 334) or lisinopril 2.5 mg (n = 167) daily for 2 weeks with subsequent titration (alone or in combination with hydroclorothiazide), depending on response to treatment. The primary efficacy variable was the percentage of patients with a response, defined as sitting diastolic blood pressure < 90 mmHg or drop of > or = 10 mmHg from baseline. A high percentage of patients responded to treatment in both valsartan and lisinopril groups: 80% for both groups at 12 weeks and 81% and 87%, respectively, at 52 weeks with no statistically significant difference between treatments (12 weeks, p = 0.925; 52 weeks, p = 0.148). More patients on lisinopril experienced drug-related cough (7.5% on valsartan, 17.4% on lisinopril). In 5.4% of lisinopril treated patients, cough led to discontinuation of therapy compared to 0.6% on valsartan. Valsartan 80 mg daily provides comparable short and long-term antihypertensive efficacy to lisinopril in elderly patients with a lower incidence of drug-related cough.
Bremner
A D
AD
Health Centre, Glasgow, Scotland, UK.
Baur
M
M
Oddou-Stock
P
P
Bodin
F
F
D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D017706:Lisinopril / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D014633:Valine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D013777:Tetrazoles; D000068756:Valsartan; D017706:Lisinopril; D014633:Valine