Once-daily irbesartan (≥50 mg) significantly reduced trough seated diastolic blood pressure compared to placebo, with reductions from baseline ranging from 7.5 to 11.6 mm Hg.
RCT (n=889)
double-blind
parallel group
Yes
Does irbesartan reduce blood pressure in a dose-dependent manner in patients with mild-to-moderate hypertension?
Once-daily irbesartan provides safe, dose-dependent reductions in blood pressure for patients with mild-to-moderate hypertension, with significant efficacy at doses of 50 mg or higher.
Two multicenter, double-blind, placebo-controlled, parallel group studies were conducted to evaluate the efficacy, safety, pharmacokinetics, and pharmacodynamics of the angiotensin II receptor (AT1 subtype) antagonist irbesartan. The effect of irbesartan withdrawal and the effect of adding hydrochlorothiazide (HCTZ) to irbesartan were also assessed. After a placebo lead-in phase, all patients were randomized to 8 weeks of double-blind therapy with either placebo (n = 158) or irbesartan at doses of 1, 5, 10, 25, 50, 100, 200, or 300 mg (n = 731 total) orally once daily. Irbesartan reduced blood pressure in a dose-related manner. Reductions from baseline in trough seated diastolic blood pressure ranged from 7.5 mm Hg for 50 mg irbesartan to 11.6 mm Hg for 300 mg irbesartan. At week 8, statistically significant reductions over placebo were observed in trough seated blood pressure with all irbesartan doses > or = 50 mg. These reductions reached statistical significance versus placebo within 2 weeks with 100, 200, and 300 mg irbesartan. Plasma irbesartan concentrations correlated with dose. Angiotensin II and aldosterone levels generally showed dose-related changes, consistent with AT1 receptor blockade. In patients not controlled at 8 weeks, the addition of 12.5 mg HCTZ resulted in further dose-related reductions in blood pressure. Irbesartan demonstrated a placebo-like safety profile and no dose-related toxicity. Irbesartan, administered alone or in combination with HCTZ, was well tolerated. Withdrawal of irbesartan did not result in rebound hypertension or adverse events. Thus, once-daily irbesartan is both an effective and safe antihypertensive agent for the treatment of mild-to-moderate hypertension.
James L. Pool (Wed,) conducted a rct in mild-to-moderate hypertension (n=889). Irbesartan vs. Placebo was evaluated on Reduction in trough seated diastolic blood pressure. Once-daily irbesartan (≥50 mg) significantly reduced trough seated diastolic blood pressure compared to placebo, with reductions from baseline ranging from 7.5 to 11.6 mm Hg.