|Dobovisek J et al.|
Efficacy and Tolerability of Losartan in Patients with Essential Hypertension: a Multicentre, Double-Blind Comparison of Losartan with Metoprolol
Journal of Clinical and Basic Cardiology 2005; 8 (1-4): 43-46
Keywords: Hypertonie, Kardiologie, Losartan, Metoprolol, cardiology, hypertension, Losartan, Metoprolol
A multicentre, randomised, double-blind, comparative study of antihypertensive efficacy and safety of losartan and metoprolol was carried out in 77 patients with mild to moderate essential hypertension. Normalisation of sitting diastolic blood pressure (siDBP) and sitting systolic blood pressure (siSBP) at the end of the study was considered as the primary criterion for evaluation. A decrease of siDBP for at least 10 % and that of siSBP for at least 15 % was considered as response to treatment. After 2 weeks of single placebo run-in period the patients were randomised to either losartan 50 to 100 mg od or metoprolol 50 to 100 mg bid. After 3 weeks of the treatment the initial dose of both drugs was doubled if target siDBP was not achieved. After 6 weeks of monotherapy hydrochlorothiazide 12.5 mg was added for the last 3 weeks if necessary. Losartan and metoprolol significantly reduced siSBP and siDBP versus baseline: –20.8/15.9 mmHg and –16.2/16.6 mmHg, respectively (all p < 0.001). There was no significant difference between the treatment regimens found during the study in regard to siSBP and siDBP decrease. In the losartan arm the primary criterion for efficacy was achieved in 72.3 % for both siSBP and siDBP. In patients treated with metoprolol these results were 63.0 and 85.2 %, respectively (n.s.). No significant differences between treatment regimens were observed in regard to complete normalisation of blood pressure (< 140/90 mmHg in single patient) and overall blood pressure response. In both groups heart rate decreased significantly and similarly. Both treatments were well tolerated. Adverse events were reported by 16.3 % of patients treated with losartan and 21.4 % of patients treated with metoprolol (n.s.). There were no serious adverse events. Conclusion: In this study in patients with mild to moderate essential hypertension, losartan in comparison with metoprolol exerted substantial and comparable antihypertensive efficacy, as well as a similar safety profile.