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 .
Effects of losartan and candesartan monotherapy and losartan/hydrochlorothiazide combination therapy in patients with mild to moderate hypertension. Losartan Trial Investigators.
OBJECTIVE The goal of this multicenter , double-blind , r and omized , parallel-group study was to compare the effects of losartan potassium ( hereafter referred to as losartan ) , c and esartan cilexitil ( hereafter referred to as c and esartan ) , and losartan/hydrochlorothiazide ( HCTZ ) in patients with mild to moderate hypertension ( sitting diastolic blood pressure [ SiDBP ] 95 - 115 mm Hg ) . METHODS A total of 1161 patients were r and omized in a 2:2:1 ratio to 12 weeks of treatment with losartan 50 mg QD , possibly titrated to 100 mg QD ( n = 461 ) ; c and esartan 8 mg QD , possibly titrated to 16 mg QD ( n = 468 ) ; or losartan 50 mg QD , possibly titrated to losartan 50 mg plus HCTZ 12.5 mg QD ( n = 232 ) . At 6 weeks , the regimens of patients not reaching a goal SiDBP < 90 mm Hg were titrated as described , whereas patients achieving this goal continued with low-dose monotherapy . The single primary end point at 12 weeks tested the equivalence of the 2 monotherapy regimens , predefined as a maximum between-treatment difference in the mean change from baseline trough SiDBP of 2.5 mm Hg . RESULTS At 12 weeks , changes in SiDBP/sitting systolic blood pressure ( SiSBP ) of -12.4/-14.4 mm Hg with losartan 50 mg/100 mg and -13.1/-15.8 mm Hg with c and esartan 8 mg/16 mg demonstrated equivalence between the 2 monotherapy regimens ( 95 % CI for difference in SiDBP , -1.6 to 0.2 ) . At 12 weeks , the losartan 50 mg/50 mg plus HCTZ 12.5 mg regimen had reduced SiDBP/SiSBP significantly more ( -14.3/-18.0 mm Hg ) than either the c and esartan 8 mg/16 mg ( SiDBP , P = 0.045 ; SiSBP , P = 0.017 ) or losartan 50 mg/100 mg regimen ( SiDBP and SiSBP , P = 0.001 ) . During the last 6 weeks , patients whose regimen had been titrated to losartan 50 mg plus HCTZ 12.5 mg ( n = 114 ) showed a greater reduction in SiDBP/SiSBP ( -14.5/ -18.7 mm Hg ) than did those whose regimen had been titrated to either losartan 100 mg ( -10.5/-12.3 mm Hg ; n = 211 ) or c and esartan 16 mg ( -11.5/-13.2 mm Hg ; n = 206 ) , representing a clinical ly meaningful > or = 2.5-mm Hg ) difference . All 3 treatments were well tolerated , with few patients experiencing drug-related adverse events ( 6.9 % losartan 50 mg/100 mg , 7.5 % c and esartan 8 mg/16 mg , 3.0 % losartan 50 mg/ 50 mg plus HCTZ 12.5 mg ) . C and esartan 8 mg/16 mg increased serum uric acid levels ( 0.13 mg/dL ; 95 % CI , 0.04 to 0.23 ) , whereas losartan 50 mg/100 mg decreased them ( -0.14 mg/dL ; 95 % CI , -0.24 to -0.04 ) , and losartan 50 mg/50 mg plus HCTZ 12.5 mg left them unchanged ( 0.06 mg/dL ; 95 % CI , -0.07 to 0.20 ) . CONCLUSIONS Losartan 50 mg/100 mg and c and esartan 8 mg/16 mg were comparable treatments in terms of blood pressure reduction . After titration , losartan 50 mg plus HCTZ 12.5 mg was superior to either c and esartan 16 mg or losartan 100 mg in reducing hypertension .  Losartan , but not c and esartan , lowered serum uric acid levels and attenuated the expected increase in uric acid levels with HCTZ 12.5 mg
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 .