Comparison of antihypertensive efficacy and tolerability of losartan and extended-release felodipine in patients with mild to moderate hypertension

Appropriate control of blood pressure has been shown to reduce morbidity an d mortality in patients with hypertension. Losartan potassium, a selective antagonist of the angiotensin II type 1 (AT1) receptor, has been shown to l ower blood pressure in patients with hypertension. The purpose of this stud y was to compare the efficacy and tolerability of losartan and extended-rel ease (ER) felodipine in Taiwanese patients with mild to moderate hypertensi on. Patients with mild to moderate hypertension (sitting diastolic blood pr essure, 95-115 mm Hg) were enrolled in this prospective, randomized, parall el study. Sitting blood pressure, heart rate, adverse reactions, and serum biochemistry values were assessed during 2 weeks of placebo and 12 weeks of active treatment. Each patient received 50 mg of losartan or 5 mg of felod ipine ER once daily, and the dosage was adjusted to double the initial leve l at week 6 if necessary. Of the 44 patients randomly allocated to receive losartan (n = 23) or felodipine (n = 21) therapy, 37 completed the study; t hree patients in the losartan group and four in the felodipine group withdr ew because of adverse experiences, or were lost to follow-up. The mean redu ctions in sitting diastolic blood pressure at 6 and 12 weeks were significa nt with both losartan (-8.6 and -11.38 mm Hg, respectively) and felodipine (-9.2 and -10.69 mm Hg, respectively), and did not differ significantly bet ween the two groups. Both losartan and ER felodipine were well tolerated by patients. However, the ER felodipine group had a significantly higher rate of drug-related flushing than the losartan group (24% vs 0%, P = 0.022). T he results indicate that once-daily administration of losartan is as effect ive and well tolerated as once-daily ER felodipine in blood pressure reduct ion.