The Effect Duration of Candesartan Cilexetil Once Daily, in Comparison with Enalapril Once Daily, in Patients with Mild to Moderate Hypertension

• Published in: Blood pressure Vol. 10; no. 1; pp. 43 - 51
• Main Authors: Himmelmänn, Anders, Keinanen-Kiukaanniemi, Sirkka, Wester, Anno, Redón, Josep, Asmar, Roland, Hedner, Thomas
• Format: Journal Article
• Language: English
• Published: Stockholm Informa UK Ltd 2001; Taylor & Francis
• Subjects: Adult; Aged; Aged, 80 and over; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Antihypertensive agents; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - adverse effects; Benzimidazoles - administration & dosage; Benzimidazoles - adverse effects; Biological and medical sciences; Biphenyl Compounds - administration & dosage; Biphenyl Compounds - adverse effects; Blood Pressure - drug effects; Cardiovascular system; Double-Blind Method; Enalapril - administration & dosage; Enalapril - adverse effects; Female; Heart Rate - drug effects; Humans; Hypertension - drug therapy; Inhibitor Angiotensin Receptor Blocker Antihypertensive Candesartan Cilexetil Enalapril Hypertension; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prodrugs - administration & dosage; Prodrugs - adverse effects; Tetrazoles; Therapeutic Equivalency; Time Factors; Human; Hypertension; Cilexetil; Candesartan; Treatment efficiency; Cardiovascular disease; Chemotherapy; Treatment; Enalapril; Antihypertensive agent; Single daily dose; Angiotensin antagonist; Angiotensin II; ACE inhibitor; Comparative study; Biological receptor
• ISSN: 0803-7051; 1651-1999
• DOI: 10.1080/080370501750183381

Objective: To determine the antihypertensive efficacy, effect duration and safety of the angiotensin II type1 receptor blocker candesartan cilexetil and the angiotensin converting enzyme inhibitor enalapril once daily in patients with mild to moderate hypertension. Methods: A multicenter, randomised, double-blind parallel group study was performed in Finland, France, the Netherlands, Spain and Sweden. Three-hundred-and-ninety-five men and women in the age range 20-80 years with primary hypertension were randomised to an 8-week double-blind treatment period with either candesartan cilexetil 8-16 mg or enalapril 10-20 mg once daily, with forced dose titration after 4 weeks. Non-invasive ambulatory blood pressure was measured for 36 h at baseline and after 8 weeks. The primary efficacy variable was the change in mean diastolic and systolic ambulatory blood pressure 22-24 h post-dose. Results: There was a significant difference in the adjusted mean difference for the change from baseline to week 8 between candesartan cilexetil and enalapril 22-24 h post-dose by -3.5 mmHg (95% confidence interval, CI: -6.8 to -0.3 mmHg; p < 0.032) in ambulatory systolic blood pressure and -3.0 mmHg (95% CI: -5.1 to -0.8 mmHg; p < 0.008) in ambulatory diastolic blood pressure. There was a significant difference in adjusted mean daytime ambulatory blood pressure 24-36 h post-dose by -4.2 mmHg (95% CI: -6.8 to -1.6 mmHg; p < 0.002)/-3.5 mmHg (95% CI: -5.1 to -1.8 mmHg; p < 0.001). Both drugs were generally well tolerated. Conclusion: The results of the present study suggest that advantages may be attributed to the use of candesartan cilexetil, as compared to enalapril in the treatment of patients with essential hypertension. In comparison with enalapril 20 mg, candesartan cilexetil 16 mg more effectively lowered blood pressure at trough and in particular on the day following the day after the last dose.