Systolic blood pressure reduction with olmesartan medoxomil versus nitrendipine in elderly patients with isolated systolic hypertension.
OBJECTIVE
The prevalence of isolated systolic hypertension (ISH) is high in the elderly, and the objective of this study was to compare the antihypertensive efficacy of olmesartan medoxomil with that of nitrendipine in elderly (65-74 years) and very elderly (>/= 75 years) male and female patients with ISH.


METHODS
Patients were randomized to 24 weeks of treatment with either olmesartan medoxomil 20 mg daily (n = 256) or nitrendipine 20 mg (n = 126) twice daily, with possible dose increase (to 40 mg daily) and addition of hydrochlorothiazide (HCTZ) 12.5 or 25 mg daily if required.


RESULTS
On the primary endpoint [reduction in mean sitting systolic blood pressure (SBP) after 12 weeks of treatment], the two treatments were similar (olmesartan medoxomil, -30.0 mmHg; nitrendipine, -31.4 mmHg). No significant difference between the treatment groups was observed, and non-inferiority of olmesartan medoxomil to nitrendipine was demonstrated using an analysis of covariance (ANCOVA) model. Reductions in mean sitting and standing SBP and diastolic blood pressure (DBP) up to week 24 were also similar with both treatments. Blood pressure (BP) goal attainment rates (sitting SBP </= 135 mmHg) increased consecutively, and were higher with olmesartan medoxomil (62.5%) than with nitrendipine (56.0%) at week 24 (not significant). Both treatments were well tolerated.


CONCLUSIONS
In elderly patients with ISH, the mean reduction in SBP produced by olmesartan is similar to that produced by nitrendipine.
Mallion
Jean-Michel
JM
Cardiologie et Hypertension Arterielle, Service de Cardiologie et Hypertension artérielle, Hopital A. Michallon CHU, BP 217-38043 Grenoble Cedex, France. jmmallion@chu-grenoble.fr
Heagerty
Anthony
A
Laeis
Petra
P
D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003971:Diastole / Q000187:drug effects; D004311:Double-Blind Method; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D007093:Imidazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009568:Nitrendipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000068557:Olmesartan Medoxomil; D012449:Safety; D013599:Systole / Q000187:drug effects; D013777:Tetrazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D007093:Imidazoles; D013777:Tetrazoles; D006852:Hydrochlorothiazide; D000068557:Olmesartan Medoxomil; D009568:Nitrendipine