Effects of Eprosartan on Pulse Pressure

Journal of Clinical and Basic Cardiology 2005; 8 (1-4): 11-14
Journal of Clinical and Basic Cardiology 2006; 9 (Sonderheft 1): 9-12

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Keywords: Angiotensin-II-Rezeptorblockade,  Eprosartan,  Hypertonie,  Kardiologie,  Pulsdruck,  angiotensin receptor blockade,  cardiology,  Eprosartan,  hypertension,  pulse pressure

Elevated systolic blood pressure, together with normal or low diastolic blood pressure, characterises isolated systolic hypertension, the most frequent form of hypertension in subjects older than 60. Pulse pressure is defined as the difference between systolic and diastolic pressures and probably reflects the rigidity of large arteries, especially the aorta. Epidemiological studies and prospective analyses of patients included in large randomised trials against placebo have demonstrated a close relationship between pulse pressure and cardiovascular morbidity and mortality. The prognostic importance of pulse pressure has lead to an increased interest in this parameter as a therapeutic target and some authors recommend that, in addition to other therapeutic goals, a reduction in pulse pressure below 50 mmHg is advisable for all hypertensive patients. Moreover, analysis of the effect on pulse pressure is also recommended in comparative trials of antihypertensive agents. Recent analyses of these comparative trials suggest that differences in pulse pressure reduction may have influenced the cardiovascular outcome. In an observational study including more than 3000 patients, eprosartan promoted a substantial reduction in pulse pressure (13.5 mmHg) that was partially independent of the mean blood pressure reduction. This effect was more pronounced in older patients and those who had isolated systolic hypertension or previous cardiovascular disease. This clinical profile of eprosartan may reflect its specific pharmacological properties and help to understand its importance in terms of cerebrovascular, cardiovascular and renal protection.