Related Experiment Video
Updated: Jul 8, 2026
08:15
Cardiac Pressure-Volume Loop Analysis Using Conductance Catheters in Mice
Published on: September 17, 2015
Higher persistence with valsartan compared with enalapril in daily practice
Satu J Siiskonen1, Nancy S Breekveldt-Postma, Gábor Vincze
1PHARMO Institute for Drug Outcomes Research, Utrecht,The Netherlands.
Vascular Health and Risk Management
|January 19, 2008
Summary
Patients taking valsartan showed higher persistence in daily practice compared to enalapril. This real-world data suggests valsartan may be a more sustainable treatment option for hypertension.
Area of Science:
- Cardiovascular medicine
- Pharmacology
- Real-world evidence
Background:
- Hypertension management relies on medication adherence.
- Comparing drug persistence is crucial for long-term treatment success.
Purpose of the Study:
- To compare medication persistence between valsartan and enalapril in a real-world setting.
- To evaluate long-term adherence to these antihypertensive agents.
Main Methods:
- Utilized the PHARMO Record Linkage System with data from over 2 million subjects.
- Identified patients newly treated with valsartan or enalapril between 1999-2002.
- Calculated persistence based on continuous treatment duration, defining persistence at 12 and 24 months.
Main Results:
- Valsartan demonstrated higher persistence rates at both 12 months (62% vs. 55%) and 24 months (48% vs. 43%) compared to enalapril.
- Patients on valsartan were approximately 20% more likely to remain on treatment than those on enalapril.
- Statistical analysis showed significant differences in persistence (1-year RR: 1.23, 2-year RR: 1.16).
Conclusions:
- Real-life persistence with valsartan is significantly higher than with enalapril.
- These findings support considering drug persistence in clinical decisions for hypertension management.
- Valsartan may offer better long-term adherence in routine clinical practice.
Related Concept Videos
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
01:22Dose-Response Relationship: Potency and Efficacy
The potency of a drug is the measure of its ability to produce a biological response and can be compared by looking at the half-maximum effective concentration or EC50 values of different drugs. A lower EC50 value indicates higher potency of the drug. In the dose–response curve of two antihypertensive drugs, candesartan and irbesartan, a significant difference is observed in their EC50 values. A lower EC50 value for candesartan indicates that it is more potent than irbesartan, as it produces...
01:25Antihypertensive Drugs: Direct Renin Inhibitors
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
01:30Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors
Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
01:08Renal Drug Clearance: Comparison Between Renal Excretion Methods
Renal clearance is a critical parameter encompassing kidney filtration, secretion, and reabsorption processes. It is calculated using a specific equation to determine the rate at which the kidneys clear a drug.
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...
Renal clearance is often associated with the renal glomerular filtration rate (GFR), which represents the rate at which plasma is filtered through the glomeruli in the kidney. When drug reabsorption is minimal and there is no active secretion, renal clearance is closely related to the...