AN INPATIENT TRIAL OF THE SAFETY AND EFFICACY OF LOSARTAN COMPARED WITH PLACEBO AND ENALAPRIL IN PATIENTS WITH ESSENTIAL-HYPERTENSION

The antihypertensive activity and safety of losartan, a specific and s elective antogonist of angiotensin II (subtype 1) receptors, was evalu ated in 100 inpatients with mild to moderate essential hypertension. A fter a 2-week, single-blind, out patient placebo lead-in period, the l ast 2 days of which included inpatient monitoring of baseline blood pr essure, the patients were assigned randomly to receive once-daily dose s of either placebo; 50, 100, or 150 mg losartan; or 10 mg enalapril. Patients were treated double blind for 5 days, followed by a day for t he study of drug withdrawal. Beginning with the first dose, the three doses of losartan and enalapril significantly decreased peak and troug h systolic and diastolic blood pressures compared with placebo (p less than or equal to 0.05). The area under the blood pressure curve was a nalyzed as an assessment of total blood pressure change throughout the day,. On day 1, total blood pressure reduction with losartan (50-150 mg) was slightly less than with enalapril, By day 5 of double-blind tr eatment, the reduction in blood pressure in these groups was similar, suggesting that losartan has a slower onset of action than enalapril. No rebound hypertension was observed after study-drug discontinuation. Losartan was well tolerated in this trial, with an adverse event prof ile similar to placebo acid enalapril.