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 ) .
Sustained antihypertensive activity of telmisartan compared with valsartan
Background Early morning blood pressure ( BP ) surge and 24 h mean BP are linked to target-organ damage and cardiovascular events . Antihypertensive agents should sustain BP control , particularly in the last 6 h of the dosing interval or if dosing is missed . The efficacies of the long half-life telmisartan compared with shorter half-life valsartan in the last 6 h of the dosing interval following active treatment and during 24 h after a missed dose were compared . Methods In two identically design ed multinational , r and omized , double-blind , forced-titration studies , hypertensive patients ( seated diastolic blood pressure ( DBP ) , 95–109 mm Hg , 24 h mean ambulatory DBP , ≥85 mm Hg ) received once-daily telmisartan ( 40–80 mg ) or valsartan ( 80–160  ) mg ) for a total of 8 weeks ; uptitration occurred after 2 weeks ' low-dose treatment . After 4 weeks ' high-dose treatment , patients were given either 1 day 's double-blind active therapy or placebo ( that is , missed dose ) . Following a further 2 weeks ' active treatment , a cross-over was performed : patients who had previously received 1 day 's placebo received active therapy and vice versa . At baseline and after the two active or missed doses , 24 h ambulatory BP monitoring was performed . Data from the studies were pooled , as prospect ively planned and analyzed using the intent-to-treat population . Results After active therapy , last 6 h mean DBP was reduced by 7.6±7.9 mm Hg with telmisartan ( n=447 ) compared with 5.8±7.8 mm Hg with valsartan ( n=430 ) ( P=0.0044 ) . Last 6 h mean systolic blood pressure ( SBP ) was reduced by 11.1 mm Hg with telmisartan compared with 9.1 mm Hg with valsartan ( P=0.0066 ) . After a missed dose , 24 h mean DBP was reduced by 7.2±6.5 mm Hg with telmisartan ( n=437 ) compared with 5.5±6.2 mm Hg with valsartan ( n=431 ) ( P=0.0004 ) . The reduction in 24 h mean SBP after a missed dose was 10.7 mm Hg with telmisartan and 8.7 mm Hg with valsartan ( P=0.0024 ) . Absence of treatment-by- study interaction indicated that pooling of studies was appropriate . All 24 hourly mean reductions in DBP and SBP were greater for telmisartan than valsartan . Both treatments were well tolerated . Conclusions Due to its longer half-life , telmisartan offers more sustained BP control , especially at the end of the dosing period and provides sustained efficacy in poorly compliant patients in the event of a missed dose with a statistical superiority compared with 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 ) .