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388
THE EFFECT OF ANGIOTENSIN RECEPTOR BLOCKER EPROSARTAN MESYLATE ON PULSE PRESSURE IN THE TREATMENT OF ISOLATED SYSTOLIC HYPERTENSION
RJ Shanlin Reiz, I Teitelbaum, M Chilvers
Toronto, Ontario
OBJECTIVES: To assess the efficacy of eprosartan (E) 600 mg od and the effect of Home Blood Pressure Monitoring (HM) in reducing sitting blood pressure (BP). Post-hoc analysis was done to assess the effect of E on BP and pulse pressure (PP) in isolated systolic hypertension (ISH) vs non-ISH patients (pts).
METHODS: Two hundred pts (60-84 yrs) with systolic BP (SBP) of 140-179 mmHg and diastolic BP (DBP)
previously treated but not controlled and/or intolerant to their current antihypertensive treatment were randomized to 10 weeks of E alone, or E with the use of an HM device (E+HMD). Hydrochlorothiazide (HCTZ) 12.5 mg od could be added at Week 4 or 6. For this post-hoc evaluation, pts were divided into 2 groups: ISH (baseline SBP ³ 140 and DBP < 90 mmHg) (n=97) vs. non-ISH (baseline SBP ³ 140 and DBP ³ 90 mmHg) (n=98).
RESULTS: E alone, or in combination with HCTZ (37%), reduced SBP at study endpoint by –17.5 ± 14.5 and –20.6 ± 14.1 mmHg, and DBP by –5.0 ± 7.9 and –12.2 ± 8.1 mmHg (P<0.0001 from baseline, t-test) in the ISH vs non-ISH pts, respectively, (SBP, P>0.05; DBP, P<0.0001 between groups, ANOVA model). There was no significant difference in the use of HCTZ between the ISH and non-ISH groups. At end of study, SBP was reduced by ³ 20 mmHg or to < 140 mmHg in 59% and 63% of pts in the ISH vs non-ISH groups. DBP was reduced by ³ 10 mmHg or to < 90 mmHg in 84% of non-ISH pts. Mean baseline PP was 76.0 ± 10.4 and 66.5 ± 10.0 mmHg (P<0.0001, ANOVA model), and was reduced from baseline at study endpoint by –12.5 ± 12.3 and ³8.4 ±11.1 mmHg in the ISH vs non-ISH groups (P<0.05, between groups, ANOVA model). The most common adverse events were mild dizziness, headache and fatigue.
CONCLUSIONS: E was effective in lowering sitting BP in both ISH and non-ISH pts with the magnitude of PP reduction being significantly greater in ISH pts. E was found to be well tolerated and safe. These data suggest that E may be especially suitable in the treatment of pts with ISH.
DC