Related Experiment Videos
Valsartan: long-term efficacy and tolerability compared to lisinopril in elderly patients with essential hypertension
A D Bremner1, M Baur, P Oddou-Stock
1Health Centre, Glasgow, Scotland, UK.
Insights
Valsartan and lisinopril show comparable efficacy in treating elderly hypertension patients. Valsartan offers a better safety profile, with significantly less drug-related cough leading to treatment discontinuation.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Geriatrics
Background:
- Essential hypertension is a prevalent condition in elderly populations.
- Angiotensin II receptor blockers (ARBs) like valsartan and Angiotensin-Converting Enzyme (ACE) inhibitors like lisinopril are common antihypertensive agents.
- Comparative efficacy and tolerability data in elderly patients are crucial for treatment selection.
Purpose of the Study:
- To compare the efficacy and tolerability of valsartan versus lisinopril in elderly patients with essential hypertension.
- To assess long-term treatment outcomes and adverse event profiles, specifically drug-related cough.
Main Methods:
- A one-year, multi-center, double-blind, parallel-group trial randomized 501 elderly patients.
- Patients received either valsartan (40 mg) or lisinopril (2.5 mg) daily, with subsequent dose titration and optional hydrochlorothiazide.
- Treatment response was defined as sitting diastolic blood pressure < 90 mmHg or a drop of ≥ 10 mmHg from baseline.
Main Results:
- High response rates were observed in both groups: 80% at 12 weeks and 81% (valsartan) vs. 87% (lisinopril) at 52 weeks, with no statistically significant difference.
- Drug-related cough was significantly more frequent in the lisinopril group (17.4%) compared to the valsartan group (7.5%).
- Cough led to treatment discontinuation in 5.4% of lisinopril patients versus 0.6% of valsartan patients.
Conclusions:
- Valsartan demonstrates comparable short- and long-term antihypertensive efficacy to lisinopril in elderly patients.
- Valsartan is associated with a significantly lower incidence of drug-related cough and subsequent treatment discontinuation.
- Valsartan represents a well-tolerated alternative for managing essential hypertension in the elderly population.
Abstract:
A total of 501 elderly patients with essential hypertension were randomized to receive valsartan or lisinopril in this one year multi-center, double-blind, parallel group trial. Patients received valsartan 40 mg (n = 334) or lisinopril 2.5 mg (n = 167) daily for 2 weeks with subsequent titration (alone or in combination with hydroclorothiazide), depending on response to treatment. The primary efficacy variable was the percentage of patients with a response, defined as sitting diastolic blood pressure < 90 mmHg or drop of > or = 10 mmHg from baseline. A high percentage of patients responded to treatment in both valsartan and lisinopril groups: 80% for both groups at 12 weeks and 81% and 87%, respectively, at 52 weeks with no statistically significant difference between treatments (12 weeks, p = 0.925; 52 weeks, p = 0.148). More patients on lisinopril experienced drug-related cough (7.5% on valsartan, 17.4% on lisinopril). In 5.4% of lisinopril treated patients, cough led to discontinuation of therapy compared to 0.6% on valsartan. Valsartan 80 mg daily provides comparable short and long-term antihypertensive efficacy to lisinopril in elderly patients with a lower incidence of drug-related cough.