EFFICACY AND TOLERABILITY OF LOSARTAN POTASSIUM AND ATENOLOL IN PATIENTS WITH MILD-TO-MODERATE ESSENTIAL-HYPERTENSION

The objective of this study was to compare the antihypertensive effica cy and tolerability of losartan potassium (losartan) and atenolol in p atients with mild-to-moderate essential hypertension. This was a multi national, prospective, randomized, 12-week double-blind parallel study with a follow-up of 4 to 10 days posttreatment to assess any adverse effects of abrupt therapy withdrawal. Two hundred two patients were ra ndomized (2: 1) to treatment with losartan or atenolol, 50 mg once dai ly. Patients were titrated after 6 weeks to 100 mg once daily if their blood pressure was uncontrolled (sitting diastolic blood pressure gre ater than or equal to 90 mm Hg). Trough sitting diastolic blood pressu re reductions at weeks 6 and 12 were similar in both the losartan (-9. 2 mm Hg and -8.3 mm Hg) and atenolol (-10.8 mm Hg and -10.1 mm Hg) gro ups and a similar percentage of patients responded to each drug. Both agents were generally well tolerated, although eight patients (two pat ients taking losartan, and six taking atenolol) were withdrawn because of clinical adverse events (P less than or equal to .05). Reduction i n pulse rate from baseline averaged 10 beats/min in the atenolol group with no pulse rate reduction observed in the losartan group (P < .01) . No evidence of rebound hypertension was observed in either group. In conclusion, losartan was as efficacious as atenolol in blood pressure reduction, and was at least as well tolerated.