Use of Ambulatory Blood Pressure Monitoring to Compare Antihypertensive Efficacy and Safety of Two Angiotensin II Receptor Antagonists, Losartan and Valsartan. Losartan Trial Investigators

Adv Ther. Mar-Apr 2000;17(2):117-31. doi: 10.1007/BF02854844.

Abstract

The efficacy and safety of losartan and valsartan were evaluated in a multicenter, double-blind, randomized trial in patients with mild to moderate essential hypertension. Blood pressure responses to once-daily treatment with either losartan 50 mg (n = 93) or valsartan 80 mg (n = 94) for 6 weeks were assessed through measurements taken in the clinic and by 24-hour ambulatory blood pressure monitoring (ABPM). Both drugs significantly reduced clinic sitting systolic (SiSBP) and diastolic blood pressure (SiDBP) at 2, 4, and 6 weeks. Maximum reductions from baseline in SiSBP and SiDBP on 24-hour ABPM were also significant with the two treatments. The reduction in blood pressure was more consistent across patients in the losartan group, as indicated by a numerically smaller variability in change from baseline on all ABPM measures, which achieved significance at peak (P = .017) and during the day (P = .002). In addition, the numerically larger smoothness index with losartan suggested a more homogeneous antihypertensive effect throughout the 24-hour dosing interval. The antihypertensive response rate was 54% with losartan and 46% with valsartan. Three days after discontinuation of therapy, SiDBP remained below baseline in 73% of losartan and 63% of valsartan patients. Both agents were generally well tolerated. Losartan, but not valsartan, significantly decreased serum uric acid an average 0.4 mg/dL at week 6. In conclusion, once-daily losartan 50 mg and valsartan 80 mg had similar antihypertensive effects in patients with mild to moderate essential hypertension. Losartan produced a more consistent blood pressure-lowering response and significantly lowered uric acid, suggesting potentially meaningful differences between these two A II receptor antagonists.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure Monitoring, Ambulatory*
  • Double-Blind Method
  • Drug Monitoring / methods*
  • Female
  • Humans
  • Losartan / therapeutic use*
  • Male
  • Middle Aged
  • Tetrazoles / therapeutic use*
  • Valine / analogs & derivatives*
  • Valine / therapeutic use
  • Valsartan

Substances

  • Antihypertensive Agents
  • Tetrazoles
  • Valsartan
  • Valine
  • Losartan