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 .
Reproducibility and clinical value of the trough-to-peak ratio of the antihypertensive effect: evidence from the sample study.
The objectives of our study were to assess the reproducibility of the trough-to-peak ratio ( T/P ) and to see whether a high T/P is accompanied by more organ protection or vice versa . The study included 175 ( mean+/-SD age , 51+/-9 years ) subjects with mild-moderate essential hypertension who had echocardiographic evidence of left ventricular ( LV ) hypertrophy taken from the SAMPLE study ( Study on Ambulatory Monitoring of Blood Pressure and Lisinopril Evaluation ) , an open-label multicenter study . The study included a 3-week washout pretreatment period , a 12-month treatment period with lisinopril ( n=84 ) or lisinopril plus hydrochlorothiazide ( n=91 ) once daily , and a 4-week placebo follow-up period . Results of 24-hour ambulatory blood pressure monitoring and echocardiographic determination of left ventricular mass index ( LVMI ) were obtained before and after 3 and 12 months of treatment . T/Ps were computed in each patient by dividing the systolic and diastolic blood pressure changes at trough ( changes in the last 2 hours of the monitoring period ) by those at peak ( average of the 2 adjacent hours with the maximal blood pressure reduction between the 2nd and 8th hour from drug intake ) after 3 and 12 months of treatment . Average 24-hour blood pressure was similarly reduced at 3 and 12 months . Trough blood pressure changes at 3 and 12 months were closely correlated , as were the corresponding peak blood pressure changes . However , the 3- and 12-month T/Ps correlated to a lesser degree ( r<0.42 ) . Furthermore , the reduction of LVMI induced by treatment was similarly correlated with the treatment-induced reduction in 24-hour average , trough , and peak blood pressures but not with the T/Ps . This was also evident when the contribution to LV hypertrophy regression by 24-hour blood pressure changes and T/Ps was assessed in a multivariate regression analysis . In patients with a T/P > /=0.5 or < 0.5 , the regression of LVMI was similar . In conclusion , peak and trough blood pressure changes are reproducible and predict the regression of LVMI induced by treatment as well as average 24-hour blood pressure . T/Ps are less reproducible , and their value does not predict regression of organ damage by antihypertensive treatment
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 .