THE EFFICACY AND TOLERABILITY OF CANDESARTAN CILEXETIL IN AN ELDERLY HYPERTENSIVE POPULATION

This study was performed to evaluate the antihypertensive efficacy and tolerability of candesartan cilexetil 8-16 mg once-daily in compariso n with placebo in elderly hypertensive patients. Forty-one hospital an d general practice centres in the Netherlands and in the United Kingdo m enrolled 350 patients over 65 years of age with essential hypertensi on (WHO grades I or II). Patients with supine diastolic BP in the rang e 95-114 mm Hg after 4- to 8-week placebo run-in period (n = 193) were randomised to double-blind therapy with candesartan cilexetil or plac ebo. The initial dose of candesartan cilexetil 8 mg or placebo was dou bled after 6 weeks if supine diastolic blood pressure (BP) exceeded 90 mm Hg. Mean (95% confidence interval) placebo-corrected reduction in supine diastolic BP after 12 weeks' treatment with candesartan cilexet il was 7.5 mm Hg (3.6-11.4; P < 0.001); the corresponding reduction in supine systolic UP was 13.6 mm Hg (6.9-20.2; P < 0.001). Placebo-corr ected mean reduction in supine diastolic BP 2 and 4 h after the first dose of candesartan cilexetil were 2.2 mm Hg (-1.3 to +5.8; P = 0.219) and 4.0 mm Hg (-0.4 to +7.6; P = 0.027), respectively. Candesartan ci lexetil had almost no influence on heart rate and did not affect the n ormal orthostatic changes in BP. Adverse events were equally common in the two treatment groups. Candesartan cilexetil 8-16 mg once-daily is an effective antihypertensive agent in elderly patients. The onset of action is smooth with no exaggerated response after the first dose an d there is no postural hypotension. Candesartan cilexetil is very well tolerated in elderly hypertensives.