TOLERABILITY OF A MODERN ANTIHYPERTENSIVE AGENT - CANDESARTAN CILEXETIL

Tolerability and not efficacy is the Limiting factor for long-term suc cessful antihypertensive treatment. Since the discontinuation rate of first line antihypertensives may be as high as 50-60 % over six months , it is important to develop new agents with an improved efficacy/tole rability ratio. Candesartan cilexetil is particularly promising in thi s respect. Candesartan is a potent and selective angiotensin II type I (AT(1)) receptor blocker that binds selectively and tightly (insumont able binding) to the receptor. Candesartan is not associated with any increased risk of cough or angiodema. It is an orally effective vasodi lator that does not cause reflex tachycardia or first dose hypotension or orthostatic hypotension. In the dose range from 4-16 mg, once dail y candesartan cilexetil is not associated with any dose-dependent adve rse events and it is equally well tolerated in men and women and by ol der (> 65 years) and younger (< 65 years) patients. Furthermore, the d rug has no adverse effect on glucose homeostasis or plasma lipid profi le. In a double-blind comparison with losartan 50 mg od, candesartan c ilexetil 16 mg once daily was significantly more effective in lowering the diastolic blood pressure at the end of the 24 h dose interval but was equally well tolerated. In meta-analyses of clinical trials, cand esartan cilexetil showed a tolerability profile comparable to that of placebo therapy.