Antihypertensive efficacy of olmesartan medoxomil and candesartan cilexetil assessed by 24-hour ambulatory blood pressure monitoring in patients with essential hypertension.
OBJECTIVE
To compare the antihypertensive efficacy of olmesartan medoxomil with that of candesartan cilexetil after 1, 2 and 8 weeks of treatment.


METHODS
Randomised, double-blind, parallel-group study conducted at 44 centres in Germany, Poland and the Czech Republic.


METHODS
643 patients (aged 19-86 years) with mainly mild-to-moderate essential hypertension received active double-blind treatment.


METHODS
Following a 2-week placebo run-in, eligible patients were randomly assigned to receive olmesartan medoxomil 20mg (n = 319) or candesartan cilexetil 8mg (n = 324) once daily for 8 weeks.


METHODS
Changes from baseline in daytime, 24-hour and night-time diastolic (DBP) and systolic (SBP) blood pressures assessed by ambulatory blood pressure monitoring (ABPM), and changes from baseline in sitting cuff DBP and SBP.


RESULTS
Mean decreases from baseline in daytime DBP by ABPM at weeks 1, 2 and 8 were 6.7, 8.4 and 9.3mm Hg, respectively, in the olmesartan medoxomil group compared with 5.3, 6.0 and 7.8mm Hg, respectively, in the candesartan cilexetil group. The between-group differences were significantly in favour of olmesartan medoxomil at all three timepoints (p </= 0.0126). Significant differences in favour of olmesartan medoxomil were also observed for mean 24-hour DBP and for mean daytime and 24-hour SBP by ABPM. Decreases from baseline in sitting cuff BP at trough were similar in the two groups (15-16mm Hg for DBP and 21mm Hg for SBP). Both treatments were well tolerated.


CONCLUSIONS
Olmesartan medoxomil reduced daytime and 24-hour DBP and SBP, assessed by ABPM, more effectively than candesartan cilexetil at the doses tested. The majority of the treatment effect in both groups was seen after only 1 or 2 weeks of dosing, when the between-group differences were already statistically significant.
Brunner
Hans R
HR
Centre Hospitalier, Universitaire Vaudois, Lausanne, Switzerland.
Stumpe
Klaus O
KO
Januszewicz
Andrzej
A