[Evaluation of blood pressure self-monitoring of the residual efficacy of telmisartan compared to perindopril. The EVERESTE study].
The aim of this multicentre, prospective, randomised, open study was to compare the trough effect of telmisartan (T) and perindopril (P) on diastolic blood pressure (DBP) after a 12-week treatment, using self blood pressure measurement (SBPM).


METHODS
To enter the study, patients had to be 18 years of age or older and were required to suffer from mild to moderate hypertension (90 < or = PAD < 110 mmHg and/or PAS < 180 mmHg). At the end of a 3-week run-in placebo period, patients were allocated to receive either T (40 mg) or P (4 mg) once daily for a period of 12 weeks. Patients whose clinic DBP remained higher than or equal to 90 mmHg at the end of the sixth week, were given a double dose regimen. SBPM was performed over 7 consecutive days at 3 different times: at the end of the washout period (W0), at week 6 (W6) and week 12 (W12). A clinic determination of blood pressure (BP) was also performed at each visit, using the same automatic device as that used for SBPM.


RESULTS
671 patients were selected and 441 were randomised (age: 55 +/- 12 years: 240 men and 201 women). Study populations were the following: the safety population (n = 441, T = 220; P = 221), the intent-to-treat (ITT) population (n = 435, T = 217 and P = 218), and the per protocol population (n = 368, T = 188; P = 180). ITT analysis showed a greater diminution of trough DBP from W0 to W12 with T than with P (T: -6.6 +/- 6.7 mmHg and P: -5.1 +/- 7.0 mmHg; p = 0.018 according to ANOVA for repeated measures). Regarding clinic BP, the same results were observed. Likewise, the per-protocol analysis provided similar findings. Doubling dose was significantly less frequent with T (41%; n = 85) than with P (55%; n = 115; p = 0.005). The overall frequency of adverse events was similar in both treatment groups: T = 34% (n = 74) vs p = 32% (n = 70). Most of them were of mild to moderate intensity and transient. As expected, the occurrence of cough was more frequent with P [5% (n = 12), T < 1% (n = 2), p = 0.007].


CONCLUSIONS
The trough effect on DBP was statistically higher with T (40 mg) than with P (4 mg), using SBPM as well as automatic clinic BP measurement.
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D001562:Benzimidazoles / Q000008:administration & dosage / Q000494:pharmacology*; D001565:Benzoates / Q000008:administration & dosage / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D020913:Perindopril / Q000008:administration & dosage / Q000494:pharmacology*; D011446:Prospective Studies; D000077333:Telmisartan
D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001565:Benzoates; D000077333:Telmisartan; D020913:Perindopril
Evaluation de l'efficacité résiduelle du telmisartan par automesure tensionnelle comparée au perindopril. Etude EVERESTE.