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Efficacy and safety of losartan
1Merck Research Laboratories, West Point, Pennsylvania, USA.
Insights
Losartan potassium, a novel angiotensin II receptor blocker, effectively lowers blood pressure in patients with essential hypertension. It demonstrates a safety profile comparable to placebo and offers a smooth 24-hour antihypertensive effect.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Clinical Trials
Background:
- Essential hypertension is a widespread condition requiring effective treatment.
- Angiotensin II receptor blockers represent a new class of antihypertensive agents.
- Losartan is the first agent in this class, targeting the type 1 angiotensin II receptor.
Purpose of the Study:
- To assess the efficacy and safety of losartan in patients with essential hypertension.
- To compare losartan's antihypertensive effects with other established drug classes.
- To evaluate the impact of combination therapy with hydrochlorothiazide.
Main Methods:
- Double-blind, controlled clinical trials involving approximately 3700 patients.
- Administration of losartan alone or in combination with hydrochlorothiazide.
- Comparison of losartan with placebo, enalapril (ACE inhibitor), felodipine (calcium channel blocker), and atenolol (beta-blocker).
Main Results:
- Losartan was effective and well-tolerated, with adverse event rates similar to placebo.
- Antihypertensive effects of losartan were comparable to enalapril, felodipine, and atenolol.
- Combination with hydrochlorothiazide significantly enhanced the antihypertensive response.
- Dizziness was the most common adverse experience; withdrawal rates were lower than placebo.
Conclusions:
- Losartan is an effective and well-tolerated antihypertensive agent for mild, moderate, and severe essential hypertension.
- It provides a smooth 24-hour blood pressure control.
- Combination therapy with hydrochlorothiazide offers additional benefits.
Abstract:
Losartan potassium (losartan) is the first of a new class of antihypertensive agents that specifically blocks the type 1 angiotensin II receptor. The efficacy and safety of losartan have been assessed in double-blind, controlled clinical trials conducted in approximately 3700 patients with uncomplicated mild, moderate and severe essential hypertension. Overall, losartan, whether administered alone or in combination with a low dose of hydrochlorothiazide (HCTZ), was effective and well-tolerated in these clinical trials, with an incidence of adverse experiences similar to that of placebo. The antihypertensive effects of losartan 50 mg once daily were similar to those of 20 mg once daily of the angiotensin-converting enzyme (ACE) inhibitor enalapril. The antihypertensive effects of losartan 50 to 100 mg once daily were similar to those of the calcium channel blocker felodipine 5 to 10 mg and to those of the beta-adrenergic blocker atenolol 50 to 100 mg once daily. Losartan was shown to have a smooth antihypertensive profile throughout the 24 h period following dosing, which mirrors the diurnal variability of blood pressure. The addition of 12.5 mg HCTZ to 50 mg losartan produced an additional significant antihypertensive response. There were no clinically meaningful differences in the antihypertensive effect of losartan when assessed by demographic subgroups of age or sex; there is a smaller antihypertensive response in Black patients. The most common patient-reported, drug-related, clinical adverse experience, with an incidence greater than that of placebo, was dizziness (2.4% versus 1.3%). The overall rate of patient withdrawal from losartan therapy due to clinical adverse experiences was lower than that of placebo (2.3% versus 3.7%).(ABSTRACT TRUNCATED AT 250 WORDS)