The relationship between dose and antihypertensive effect for different AT1-receptor blockers.
Hypertensive patients require adequate control of blood pressure to limit the development of cardiovascular complications. The introduction of the angiotensin II type I (AT1)-receptor blockers was an important breakthrough, offering effective control of blood pressure with placebo-like tolerability. The relationship between dose and antihypertensive effect has been more or less well defined for the different AT1-receptor blockers currently available. Attempts to compare the antihypertensive effects of different AT1-receptor blockers using meta-analyses of several studies have been performed, although the results of such analyses are often limited by the inconsistencies of included trials and the inability to examine primary data and methodology. Furthermore, it is important to include data from the most up-to-date studies and to ensure correction of placebo effects, which tend to differ considerably between studies and contribute in varying degrees to the apparent therapeutic efficacies observed. Consequently, while meta-analysis can be useful in determining dose-response relationships for individual drugs, randomized, prospective, double-blind, head-to-head comparative studies are the only accurate means of comparing efficacy between drugs. A number of such trials have confirmed the superior efficacy of candesartan cilexetil and irbesartan compared with losartan in terms of reduction in blood pressure and maintenance of antihypertensive efficacy between doses.
Hansson
L
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Department of Geriatrics, Clinical Hypertension Research, University of Uppsala, Sweden.
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D015201:Meta-Analysis as Topic; D044140:Receptor, Angiotensin, Type 1; D013810:Therapeutic Equivalency
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D044140:Receptor, Angiotensin, Type 1