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 .
A comparison of the efficacy and duration of action of candesartan cilexetil and losartan as assessed by clinic and ambulatory blood pressure after a missed dose, in truly hypertensive patients: a placebo-controlled, forced titration study. Candesartan/Losartan study investigators.
The purpose of this double-blind , forced titration study was to compare the antihypertensive effect duration of c and esartan cilexetil , which has a longlasting binding to the human AT1-receptor , to that of losartan on ambulatory BP ( ABP ) not only during the 24-h dosing interval but also during the day of a missed dose intake . After a 4-week placebo lead-in period , 268 patients with sitting diastolic BP 95 to 110 mm Hg and mean awake ambulatory DBP > or = 85 mm Hg were r and omized to receive either 8 mg of c and esartan , 50 mg of losartan , or placebo for a 4-week period . Thereafter , the doses were doubled in all patients for an additional 4-week period . Ambulatory BP monitoring was performed for 36 h after dosing and clinic BP measured 48 h after dosing . C and esartan cilexetil ( 16 mg ) reduced ABP to a significantly greater extent than 100 mg of losartan , particularly for systolic ABP during daytime ( P<.05 ) , nighttime ( P<.05 ) , and 24-h ( P<.01 ) periods , systolic ( P<.01 ) and diastolic ( P<.05 ) ABP between 0 and 36 h , and both systolic ( P<.001 ) and diastolic ( P<0.001 ) ABP during the day of a missed dose . Clinic BP at 48 h after dosing was significantly reduced exclusively with 16 mg of c and esartan . The differences in BP reduction between 8 mg of c and esartan and 50 mg of losartan were statistically significant for systolic ABP during daytime ( P<.01 ) , nighttime ( P<.05 ) , 24-h ( P<.01 ) , 0 to 36 h ( P<.05 ) and during the day of missed dose ( P<.05 ) . Moreover , although losartan did not significantly reduce ambulatory BP in a dose-related manner , ambulatory systolic and diastolic BP reductions with 16 mg of c and esartan were significantly greater ( P<.01 and < .001 ) than those seen with 8 mg of c and esartan during every period at the ABP supporting a dose-response relationship . In conclusion , this forced titration study in ambulatory hypertensive patients demonstrates that c and esartan cilexetil provides significant dose-dependent reduction in both clinic and ambulatory BP in doses ranging from 8 to 16 mg once daily . Furthermore , c and esartan cilexetil is superior to losartan in reducing systolic ABP and in controlling both systolic and diastolic ABP on the day of a missed dose . The differences observed between both agents are most likely attributable to a tighter binding to , and a slower dissociation from , the receptor binding site with c and esartan cilexetil
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 .