RESULTS The global antihypertensive activity of ARB differs from that observed with amlodipine in the sense that the magnitude of the reduction in the BP values does not essentially depend on the initial BP values nor on the dose used .
When only ARB were considered , the drug used was a determinant for systolic BP reduction , whereas for diastolic BP the influence was on the BP reduction and the duration of the antihypertensive activity .
The dose used had a particular influence on the duration of the antihypertensive activity for both systolic and diastolic BP .
CONCLUSION Among the ARB , the influence is on duration more than on the magnitude of BP reduction .
Dose , therefore , is an important factor in the duration of antihypertensive activity
OBJECTIVE To perform a systematic review of the antihypertensive activity of the angiotensin II AT1 receptor antagonists ( ARB ) .
Use of 24-Hour Ambulatory Blood Pressure Monitoring to Assess Antihypertensive Efficacy
Abstract Introduction : Goal rates , the percentage of patients with hypertension achieving recommended SBP/DBP , are a clinical ly important assessment of an antihypertensive agent ’ efficacy . Twenty-four-hour ambulatory blood pressure monitoring ( ABPM ) allows accurate assessment of a patient ’s hypertension and risk for cardiovascular events , and provides the most accurate measure of an antihypertensive agent ’s efficacy throughout a 24-hour dosing interval . Methods : A 12-week ( 4-week single-blind placebo run-in phase followed by an 8-week double-blind active treatment phase ) r and omized , parallel-group study reported that the recommended starting dose of the angiotensin II receptor antagonist ( angiotensin receptor blocker ; ARB ) olmesartan medoxomil ( Benicar ™ ) 20 mg/day was more effective than starting doses of losartan potassium ( Cozaar ® ) 50 mg/day , valsartan ( Diovan ® ) 80 mg/day , or irbesartan ( Avapro ® ) 150 mg/day in reducing cuff DBP in patients with essential hypertension . The present report includes analyses of secondary efficacy variables from this 12-week trial . Results : The mean reduction in blood pressure from baseline to week 8 ( end of treatment ) was significantly greater with olmesartan medoxomil than with valsartan for all ABPM times analyzed ( 24 hours , daytime , night-time , and last 2 and 4 hours of monitoring ) . Statistical significance was reached for comparisons of oimesartan medoxomil with losartan potassium for a majority of times analyzed and with irbesartan for SBP in the last 4 hours of monitoring . Goal rates for accepted critical ambulatory blood pressure ( ABP ) values of < 130/80 mm Hg for mean 24-hour ABP , < 135/85 mm Hg for mean daytime ABP , and < 120/75 mm Hg for mean night-time ABP were significantly greater for patients receiving olmesartan medoxomil than for those receiving losartan potassium or valsartan . Goal rates were numerically superior , but not statistically significant , to those achieved with irbesartan . Compared with losartan potassium or valsartan recipients , a significantly higher percentage of patients treated with olmesartan medoxomil achieved the 24-hour ABP goal of < 130/85 mm Hg . The last 2 and 4 hours of ABPM indicated that olmesartan medoxomil maintained larger mean decreases in blood pressure through the morning surge . Discussion / Conclusion : ABP goal rates are a meaningful measure of antihypertensive efficacy . The effects on mean change from baseline in ABP and ABP goal rates after 8 weeks of treatment were numerically better , but not statistically significant , for olmesartan medoxomil than for irbesartan . However , olmesartan medoxomil was significantly more effective than losartan potassium or valsartan
RESULTS The global antihypertensive activity of ARB differs from that observed with amlodipine in the sense that the magnitude of the reduction in the BP values does not essentially depend on the initial BP values nor on the dose used .
When only ARB were considered , the drug used was a determinant for systolic BP reduction , whereas for diastolic BP the influence was on the BP reduction and the duration of the antihypertensive activity .
The dose used had a particular influence on the duration of the antihypertensive activity for both systolic and diastolic BP .
CONCLUSION Among the ARB , the influence is on duration more than on the magnitude of BP reduction .
Dose , therefore , is an important factor in the duration of antihypertensive activity
OBJECTIVE To perform a systematic review of the antihypertensive activity of the angiotensin II AT1 receptor antagonists ( ARB ) .