Safety Of Eprosartan Research Articles

Antihypertensive effects and safety of eprosartan: a meta-analysis of randomized controlled trials

The benefits of reducing blood pressure (BP) have been well established, but uncertainty remains about the comparative effects of different BP-lowering regimens. We aimed to estimate the efficacy and the tolerability of eprosartan compared with other agents as monotherapy. PubMed, EMBASE, and Cochrane Library were searched for relevant studies. A meta-analysis of randomized controlled trials (RCTs) meeting the criteria was performed using Review Manager and Stata/SE. Twenty-two articles were ultimately included out of 78 studies, involving 6,460 patients. Eprosartan had a greater systolic blood pressure (SBP) reduction than placebo [weighted mean difference (WMD): 6.55, 95% confidence interval (CI) 4.86-8.25] and losartan (WMD: 2.24, 95% CI 0.08-4.40) and a greater diastolic blood pressure (DBP) reduction than placebo (WMD 3.95, 95% CI 2.77-5.13). Therapeutic response rate of BP favored eprosartan [risk ratio (RR) 1.13, 95% CI 1.03-1.24] compared with enalapril. There were no statistical differences in SBP or DBP reductions comparing eprosartan with enalapril or telmisartan. Original RCTs included comparing eprosartan with valsartan and nitrendipine reported no differences in BP-lowering efficacy. Eprosartan monotherapy is equivalent to many first-line antihypertensive agents and is effective for the treatment of essential hypertension, especially for isolated systolic hypertension. The favorable efficacy and tolerability make eprosartan worthwhile to be taken into consideration by physicians.

Effectiveness of eprosartan in diabetic hypertensive patients

Background The aim of this study was to compare the effectiveness and safety of eprosartan in reducing blood pressure in a group of diabetic patients and a group of non-diabetic patients in a primary care setting. Methods The ESTEPP (Efficacy and Safety of Treatment with Eprosartan on Pulse Pressure) study was open, prospective, multi-centered, and observational. It compared the results obtained from diabetic ( n = 114, age 65.0 ± 10.7 years, 46.4% men and 53.6% women) and non-diabetic patients ( n = 435, age 62.5 ± 11.4 years, 45.8% men and 54.2% women). All patients had mild to moderate hypertension (VI JNC) and were treated with eprosartan (600 mg) once daily. They had four follow-up visits in 16 weeks. At each visit, blood pressure (using a semiautomatic OMRON 705CP device), adverse effects, and treatment compliance were checked. Results Blood pressure decreased significantly ( P < 0.0001) in both diabetic and non-diabetic patients: SBP (25.9 mmHg vs. 26 mmHg), DBP (12.5 mmHg vs. 13.2 mmHg), MAP (16.9 mmHg vs. 17.5 mmHg), and pulse pressure (13.4 mmHg vs. 12.8 mmHg). Pulse pressure/MAP ratio showed a significant reduction in diabetics (baseline: 64 ± 15%; final: 61 ± 12%) and non-diabetics (baseline: 61 ± 14%; final: 58 ± 11%). The adverse effect rate was 7% in diabetic patients and 2.8% in non-diabetics. Treatment compliance did not differ between the groups (diabetics 98.0%, non-diabetics 92.2%). Conclusions Eprosartan seems to be effective in reducing SBP, DBP, and pulse pressure in hypertensive subjects and to the same extent in both diabetic and non-diabetic patients.

Effectiveness and safety of eprosartan on pulse pressure for the treatment of hypertensive patients

A multicentre, prospective, non-comparative open-label study was conducted to assess the effect of eprosartan, 600 mg/day, on pulse pressure (PP) in patients with hypertension (stage I or II, Joint National Committee, sixth report) treated in the primary care setting, as well as safety and compliance. The duration of treatment was 16 weeks. Eprosartan decreased PP (-13 mmHg), systolic blood pressure (SBP) (-26 mmHg), diastolic blood pressure (DBP) (-13 mmHg) and mean arterial pressure (MAP) (-17.4 mmHg) significantly (p < 0.0001). The PP/MAP ratio changed significantly from 62 to 59%, so that the reduction of PP was 3% higher than the overall decrease in MAP. Twenty adverse events, mostly gastrointestinal complaints, were recorded in 12 patients (1.9%). Compliance with treatment at the end of the study was 94%. Eprosartan was a well-tolerated and an effective drug in reducing PP, SBP and DBP below the recommended levels in patients with mild-to-moderate essential hypertension, allowing a high therapeutic compliance.

Eprosartan versus Enalapril in Elderly Patients with Hypertension: a Doubleblind, Randomized Trial

Aim : To compare the efficacy and safety of eprosartan and enalapril to lower systolic blood pressure in elderly patients with essential hypertension. Methods : 334 patients >65 years with sitting systolic blood pressure (sitSBP) S 160 mmHg and diastolic blood pressure (sitDBP) 90–114 mmHg were randomized to 12 weeks of double-blind treatment with eprosartan, 600–800 mg once daily (o.d.) or enalapril (5–20 mg o.d.), with flexible dose titration to lower systolic blood pressure below 140 mmHg. The primary outcome measure was change in sitSBP at endpoint. Results : Least-squares mean changes from baseline in sitSBP were–18.0 and–17.4 mmHg in the eprosartan and enalapril groups, respectively (difference eprosartan– enalapril–0.6, 95% confidence interval, CI,–4.1 to 3.0, p = 0.76). The corresponding figures for sitDBP were–9.4 and–9.6 mmHg (difference eprosartan–enalapril 0.2, 95% CI–1.7 to 2.0, p = 0.84). Normalization and response rates were also similar in the two groups. Adverse events were recorded in 61 (35.7%) patients on eprosartan (one with dry cough) and 83 (50.9%) patients on enalapril (10 with dry cough). Conclusions : Eprosartan and enalapril were equally effective in reducing sitSBP and sitDBP in elderly patients with predominantly systolic hypertension. Eprosartan was better tolerated and, in particular, lacked the propensity of enalapril to cause dry cough.

Efficacy and Safety of Eprosartan in Severe Hypertension

The efficacy of eprosartan, a highly selective, orally-active non-biphenyl, non-tetrazole, type 1 angiotensin II (AT1) receptor antagonist, was compared with that of the angiotensin-converting enzyme (ACE) inhibitor, enalapril, with the addition of hydrochlorothiazide (HCTZ) when necessary in patients with severe hypertension (sitting diastolic blood pressure [sitDBP] > or = 115 mmHg and < or = 125 mmHg). Patients (n = 118) were randomized into an 8-week, double-blind titration phase and were started on oral eprosartan 400 mg total daily dose, given b.i.d., or oral enalapril 10 mg total daily dose, given o.d. The dose of eprosartan was increased to 600 and 800 mg daily, given b.i.d., and that of enalapril to 20 and 40 mg daily, given o.d., at weeks 2 and 4 if sitDBP was > or = 90 mmHg. If blood pressure remained uncontrolled on maximum doses of eprosartan or enalapril at week 6, HCTZ 25 mg o.d. was added to the treatment regimen. Patients whose blood pressure was deemed medically acceptable by the investigator at week 8 entered a 2-week maintenance phase on the final dose used in the titration phase. The primary efficacy measure was the difference between treatments of the mean reduction from baseline in sitDBP at the end of the study. Eprosartan and enalapril caused a similar reduction in sitDBP at study endpoint. The mean change in sitDBP at the end of the study for the eprosartan group was -20.1 mmHg vs -16.2 mmHg for the enalapril group. However, eprosartan produced significantly greater decreases in both sitting and standing systolic blood pressure (sitSBP and staSBP, respectively) than enalapril. The mean decrease in sitSBP was 29.1 mmHg for eprosartan compared with 21.1 mmHg for enalapril (p = 0.025). The mean reduction in staSBP was 27.8 mmHg for eprosartan compared with 20.0 mmHg for enalapril (p = 0.032). At the end of the study, the response rate (sitDBP < 90 mmHg or decreased from baseline by at least 15 mmHg) was 69.5% in the eprosartan group and 54.2% in the enalapril group. The proportion of patients in each treatment group who required addition of HCTZ was similar. Eprosartan was well tolerated; the overall incidence of adverse events was comparable to that in the enalapril group. These results demonstrate that in patients with severe hypertension, eprosartan is well tolerated and may be more effective than enalapril in reducing systolic blood pressure.

D039 Safety of eprosartan in elderly patients with hypertension

D039 Safety of eprosartan in elderly patients with hypertension

D57 Results of a 13-week, double-blind, placebo-controlled study of the efficacy and safety of eprosartan in patients with essential hypertension

D57 Results of a 13-week, double-blind, placebo-controlled study of the efficacy and safety of eprosartan in patients with essential hypertension