Switching from ACE inhibitors, beta-blockers, calcium antagonists or diuretics to candesartan improves efficacy and tolerability.
OBJECTIVE
To evaluate the efficacy and safety of candesartan in patients previously treated with, but displaying adverse reactions to, ACE inhibitors, beta-blockers, calcium antagonists or thiazide diuretics.


METHODS
968 mild to moderate essential hypertensive patients (aged 18-74 years) entered an 8-week treatment period with candesartan 8 or 16 mg according to a multicenter, randomized, open-label, parallel-group design. After the first 4 weeks of treatment, candesartan was doubled in 33.6% of patients taking the 8-mg dose, in whom blood pressure was > 140/90 mmHg.


RESULTS
Sitting diastolic and systolic blood pressures were significantly reduced (mean and 95% confidence interval) after 4 [3.7 (3.2-4.2)/8.9 (8.0-9.9) mmHg; n = 930] and even more after 8 [5.8 (5.4-6.3)/12.1 (11.1-13.0) mmHg; n = 890] weeks of treatment. The rate of improvement in the tolerability profile (success) was always greater than the rate of failure (93.3 vs 6.7% at the end of treatment). Adverse reactions amounted to 1125 at baseline, 129 at 4 weeks and 46 at 8 weeks of treatment. Adverse events to candesartan were reported in 2.7% of patients. Efficacy and safety were similar when data were analyzed taking into account the type of previous antihypertensive treatment.


CONCLUSIONS
Candesartan is an effective and safe alternative to common antihypertensive drugs when they are not tolerated by patients.
Porcellati
Carlo
C
Omboni
Stefano
S
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D001581:Benzothiadiazines; D001713:Biphenyl Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004232:Diuretics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D049993:Sodium Chloride Symporter Inhibitors / Q000627:therapeutic use; D013777:Tetrazoles
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001581:Benzothiadiazines; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors; D013777:Tetrazoles; C077793:candesartan cilexetil