Why the study?
Do angiotensin II receptor antagonists improve cardiovascular morbidity and mortality compared to conventional antihypertensive agents in patients with hypertension?
Do angiotensin II receptor antagonists improve cardiovascular morbidity and mortality compared to conventional antihypertensive agents in patients with hypertension?
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Angiotensin II receptor antagonists, particularly losartan and irbesartan, offer cardiovascular morbidity and mortality benefits beyond simple blood pressure reduction in high-risk hypertensive patients.
Antihypertensive efficacy must be redefined beyond blood pressure (BP) lowering per se to include reducing the cardiovascular complications of hypertension. Treatment decisions should be based on results from large clinical trials with relevant clinical outcomes. Several recent morbidity and mortality trials with angiotensin II receptor antagonists (AIIAs) provide an evidence-based rationale for the use of AIIAs in patients with hypertension. Studies with AIIAs in comparison to conventional antihypertensive agents showed improved morbidity and mortality outcomes in patients with hypertension and left ventricular hypertrophy (losartan) and diabetes mellitus (losartan and irbesartan). Trials with some members of the AIIA class (candesartan and valsartan) have not demonstrated such benefits in comparison to conventional agents, possibly due to differences in BP control during the trials. The results of these AIIA outcome trials have impacted on recently issued clinical guidelines for management of hypertension.
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Paul R. Conlin (2005) studied this question.
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