J. Scholze et M. Stapff, START OF THERAPY WITH THE ANGIOTENSIN-II ANTAGONIST LOSARTAN AFTER IMMEDIATE SWITCH FROM PRETREATMENT WITH AN ACE-INHIBITOR, British journal of clinical pharmacology, 46(2), 1998, pp. 169-172
Aims To evaluate initial blood pressure effects of the angiotensin II
antagonist losartan (L) immediately after switching from an ACE inhibi
tor (captopril, C). Methods Two-phase multicentre randomized study in
177 outpatients with mild to moderate essential hypertension. For 6 we
eks all patients received 25 mg C twice daily. Then they were randomiz
ed double-blind to switch for another 6 weeks to 50 mg L once daily (n
=110) or to maintain C (n=55). On the first day of the switch they und
erwent ambulatory blood pressure measurement (ABPM). Results Within 12
h of first dose, 31% of patients who switched to L had two consecutiv
e systolic BP readings of 30 mmHg below their individual baseline valu
e compared with 24% of patients who stayed on C. In 3% of, patients wi
th L and in 6% of the C patients systolic BP readings less than 100 mm
Hg were recorded within 12 h of first dose. The differences were not s
tatistically significant. There were no clinical symptoms attributable
to initial hypotension. During the 6 weeks double-blind therapy, 9% o
f L patients experienced at least one adverse event, compared with 16%
of patients with C. Conclusions In this study the angiotensin II anta
gonist losartan was effective and generally well tolerated when admini
stered immediately after pretreatment with an ACE inhibitor.