The angiotensin receptor blocker eprosartan mesylate reduces pulse pressure in isolated systolic hypertension.
BACKGROUND
Isolated systolic hypertension (ISH) is a common and particularly poorly controlled form of hypertension.


OBJECTIVE
To assess the effect of eprosartan 600 mg tablet once daily on blood pressure (BP), pulse pressure, BP response, compliance and safety in subjects with ISH compared with subjects with combined systolic-diastolic hypertension (non-ISH).


METHODS
The present study is a post hoc evaluation of a prospective, randomized, open-label, multicentre study. Subjects 60 to 84 years old with ISH (systolic BP 140 mmHg or greater with diastolic BP less than 90 mmHg) (n=97) or non-ISH (systolic BP 140 mmHg or greater with diastolic BP 90 mmHg or greater) (n=98) received 10 weeks of treatment with either eprosartan alone or eprosartan plus home BP monitoring.


RESULTS
Eprosartan significantly reduced systolic BP at the study end point from baseline in both the ISH group and the non-ISH group (-17.5+/-14.5 mmHg and -20.6+/-14.1 mmHg [mean +/- SD], respectively; P<0.0001). The reduction in diastolic BP was significantly greater in subjects with non-ISH than in those with ISH (-12.2+/-8.1 mmHg and -5.0+/-7.9 mmHg, respectively; P<0.0001). Mean pulse pressure was significantly reduced from baseline in both groups (P<0.0001), but was reduced to a significantly greater degree in the ISH group than in the non-ISH group (-12.5+/-12.3 mmHg and -8.4+/-11.1 mmHg, respectively; P<0.05). The most common adverse events were dizziness, headache and fatigue.


CONCLUSIONS
Eprosartan effectively lowered BP and pulse pressure in all subjects. The magnitude of pulse pressure reduction was significantly greater in the ISH group, and the diastolic BP reduction was greater in the non-ISH group, suggesting that eprosartan may be especially suitable in the treatment of subjects with ISH.
Teitelbaum
Ivor
I
Yorkview Medical Centre, Downsview, Canada.
Chilvers
Martyn
M
Reiz
Ruby J Shanlin
RJ
D000179:Acrylates / Q000008:administration & dosage* / Q000009:adverse effects; D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination; D002170:Canada; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011336:Probability; D012016:Reference Values; D012720:Severity of Illness Index; D013599:Systole / Q000187:drug effects; D013876:Thiophenes / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
D000179:Acrylates; D047228:Angiotensin II Type 1 Receptor Blockers; D007093:Imidazoles; D013876:Thiophenes; C068373:eprosartan