Conclusions : C and esartan is superior to losartan in reducing blood pressure .
C and esartan also causes fewer serious adverse events than losartan
Background : C and esartan is a relatively novel antihypertensive agent of the angiotensin receptor blocker ( ARB ) .
Several clinical trials have compared c and esartan with losartan in the management of essential hypertension .
However , systematic assessment of efficacy and safety between c and esartan and losartan is still lacking .
The smoothness index: A new, reproducible and clinically relevant measure of the homogeneity of the blood pressure reduction with treatment for hypertension
Objective To introduce a new method , the smoothness index , for assessing the homogeneity of 24 h blood pressure reduction by antihypertensive treatment and to compare it with the trough : peak ratio ; and to assess the ability of both indices to predict a reduction in the left ventricular mass index induced by treatment . Patients and methods In 174 patients with essential hypertension and left ventricular hypertrophy , enrolled in the Study on Ambulatory Monitoring of Pressure and Lisinopril Evaluation ( SAMPLE ) , aged 20–65 years , we measured clinic blood pressure , 24 h ambulatory blood pressure and the left ventricular mass index ( echocardiography ) before and after treatment with lisinopril at 20 mg with the addition of 12.5 or 25 mg hydrochlorothiazide as needed to reach a sufficient blood pressure reduction . The following parameters were computed for systolic and diastolic ambulatory blood pressure : ( 1 ) hourly and 24 h blood pressure averages ( ± SD ) at baseline and after 3 and 12 months of treatment ; ( 2 ) hourly blood pressure changes from baseline after 3 and 12 months of treatment , and their average ( ± SD ) over 24 h ; ( 3 ) the trough : peak ratio after 3 and 12 months of treatment ; and ( 4 ) the smoothness index after 3 and 12 months of treatment . Similar calculations were also performed at the end of a final study month during which active treatment was withdrawn and placebo was substituted ( n = 164 ) . Results The smoothness index for systolic and diastolic ambulatory blood pressure computed after 3 months of treatment was more closely related to its corresponding values after 12 months of treatment than the trough : peak ratio values computed after the same time periods were ( r = 0.68 versus 0.38 for systolic and 0.68 versus 0.42 for diastolic blood pressure , respectively ) . The smoothness index showed an inverse correlation with the 24 h st and ard deviation of systolic and diastolic blood pressure ( r = −0.25 and −0.16 , P < 0.01 and < 0.05 , respectively , for 12 months of treatment ) , while the trough : peak ratio did not ( r = −0.01 to −0.12 , NS ) . A treatment-induced reduction in the left ventricular mass index was related to the smoothness index for systolic and diastolic blood pressure ( r = −0.35 and −0.32 , P < 0.001 with 12 months of treatment ) , but not to the corresponding trough : peak ratios . Conclusions The smoothness index identifies the occurrence of a balanced 24 h blood pressure reduction with treatment and correlates with the favourable effects of treatment on left ventricular hypertrophy better than the commonly used trough : peak ratio
Conclusions : C and esartan is superior to losartan in reducing blood pressure .
C and esartan also causes fewer serious adverse events than losartan
Background : C and esartan is a relatively novel antihypertensive agent of the angiotensin receptor blocker ( ARB ) .
Several clinical trials have compared c and esartan with losartan in the management of essential hypertension .
However , systematic assessment of efficacy and safety between c and esartan and losartan is still lacking .