LOSARTAN POTASSIUM AS INITIAL THERAPY IN PATIENTS WITH SEVERE HYPERTENSION

Citation
Mc. Dunlay et al., LOSARTAN POTASSIUM AS INITIAL THERAPY IN PATIENTS WITH SEVERE HYPERTENSION, Journal of human hypertension, 9(11), 1995, pp. 861-867
Citations number
NO
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
09509240
Volume
9
Issue
11
Year of publication
1995
Pages
861 - 867
Database
ISI
SICI code
0950-9240(1995)9:11<861:LPAITI>2.0.ZU;2-7
Abstract
This 12-week, open-label study was conducted to gain experience with l osartan potassium, an angiotensin II receptor antagonist, in patients with severe hypertension. Patients were either untreated or withdrawn from current therapy for at least 48 h before initiation of losartan 5 0 mg once daily. Patients were titrated to 100 mg as needed to achieve a goal of sitting diastolic blood pressure (SiDBP) 90 or 95 mm Hg. Hy drochlorothiazide (12.5 mg once daily titrated to 25mg) was added and followed by either a dihydropyridine calcium channel blocker (CCB) and /or atenolol, if BP was not controlled. A total of 179 patients with a pretreatment mean baseline BP of 172 +/- 17/112 +/- 18 mm Hg enrolled in the trial and BP was recorded 24 h after dosing at baseline and we eks 2, 4, 8 and the final week (10-12 weeks). The mean reductions in S IDBP from baseline were 7.3, 9.3, 15.9 and 18.9 mmHg, respectively, an d these changes from baseline were statistically significant, P<0.001. At the end of the trial, 22% of patients remained on losartan monothe rapy, 30% required the addition of hydrochlorothiazide (HCTZ) and 31% required both HCTZ and a CCB; 11% required HCTZ and atenolol while 4% required HCTZ, a CCB and atenolol; 2% of patients were on regimens not specified by the protocol. SIDBP < 90 mm Hg was achieved in 68 patien ts by the final visit; 24% of these patients were treated with losarta n monotherapy (50 or 100 mg), 41% achieved control with the addition o f HCTZ (12.5 or 25 mg) and 24% required triple therapy which included losartan, HCTZ and a CCB. As assessed by the investi; gator, 25% of th e patients in the study had drug-related clinical adverse experiences. Headache was the most frequently reported clinical adverse event (26% of patients). Mo clinically significant changes in laboratory paramet ers were observed. it is concluded that losartan potassium can be used as initial therapy for patients with severe hypertension and can be a dministered concurrently with hydrochlorothiazide, calcium channel blo ckers and atenolol.