Eprosartan mesylate effectively reduces systolic and diastolic blood pressure in a Canadian primary care setting.
BACKGROUND
Evidence suggests that antihypertensive agents may have differential effects on systolic blood pressure (SBP) and that home BP monitoring (HBPM) may enhance the antihypertensive effects.


OBJECTIVE
To evaluate the efficacy and safety of eprosartan mesylate in the treatment of hypertension, particularly on SBP in older subjects, and to assess the role of HBPM.


METHODS
A randomized, open-label, 10-week study was conducted in 35 primary care centres across Canada. One hundred ninety-eight subjects (aged 60 to 84 years) with mild to moderate hypertension (SBP 140 mmHg to 179 mmHg, diastolic BP [DBP] 109 mmHg or less) were included in the analysis. All subjects received open-label eprosartan mesylate 600 mg once daily, and were randomly assigned to eprosartan treatment alone or eprosartan plus HBPM. Hydrochlorothiazide 12.5 mg once daily could be added after week 4. The primary outcomes were the change in SBP at study end and the effect of HBPM on SBP.


RESULTS
In the eprosartan and eprosartan plus HBPM groups, SBP was reduced by 17.6 mmHg and 19.9 mmHg, and DBP was reduced by 8.7 mmHg and 8.5 mmHg, with a systolic pressure response of 58% and 65%, respectively. HBPM had no additional benefits. Eprosartan was well tolerated, with the majority of adverse events being mild to moderate.


CONCLUSIONS
Eprosartan alone or in combination with hydrochlorothiazide was highly effective and safe in lowering blood pressure, notably SBP, in older subjects with mild to moderate hypertension.
Conter
Howard S
HS
MSHJ Research Associates, Halifax, Nova Scotia.
McKay
Donald W
DW
Reiz
Ruby J Shanlin
RJ
D000179:Acrylates / Q000008:administration & dosage* / Q000009:adverse effects; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage* / Q000009:adverse effects; D001795:Blood Pressure Determination; D002170:Canada; D003971:Diastole / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage* / Q000009:adverse effects; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D012720:Severity of Illness Index; D016037:Single-Blind Method; 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; D006852:Hydrochlorothiazide; C068373:eprosartan