Key result
Irbesartan provided dose-dependent blood pressure lowering, with the 150 mg dose yielding placebo-subtracted reductions of ~8/5 mm Hg and a 56% favorable response rate.
Why the study?
Does oral irbesartan once daily reduce blood pressure in adults with a seated diastolic blood pressure of 95 to 110 mm Hg?
Meta-Analysis (n=2,955)
double-blind
randomized
Yes
Does oral irbesartan once daily reduce blood pressure in adults with a seated diastolic blood pressure of 95 to 110 mm Hg?
Irbesartan provides dose-dependent blood pressure lowering in hypertensive adults, with efficacy plateauing at doses of 300 mg or greater.
Answers are grounded in this paper and cite their sources.
Irbesartan lowers BP across doses; reinforces ARB efficacy and informs once-daily dosing in hypertension.
Results of eight multicenter, randomized, placebo-controlled, double-blind, parallel-group studies were pooled to assess the efficacy of the angiotensin II-receptor blocker irbesartan over the dose range of 1 to 900 mg. A total of 2955 adults with a seated diastolic blood pressure of 95 to 110 mm Hg were randomized to treatment with oral irbesartan once daily or placebo for 6 to 8 weeks. Office blood pressure was measured at trough (24+/-3 hours after the last dose) and peak (3+/-1 hours after the last dose) by mercury sphygmomanometry. Demographic characteristics (mean blood pressure; 151/101 mm Hg; mean age, 54 years; 63% male; and 82% white) were similar across all dose groups. After the groups were pooled, antihypertensive efficacy was assessed by therapeutic response (trough seated diastolic blood pressure <90 mm Hg or a reduction from baseline of > or = 10 mm Hg) and by modeling of the maximum reductions in trough and peak seated diastolic and systolic blood pressure. Antihypertensive effects increased with increasing doses and reached a plateau at > or = 300 mg. Irbesartan 150 mg provided placebo-subtracted reductions in trough seated systolic and diastolic blood pressure of approximately 8 and approximately 5 mm Hg, respectively, with 56% of patients displaying a favorable response. In conclusion, irbesartan provides clinically significant blood pressure lowering, with a clear relationship between (log) dose and antihypertensive effect.
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Reeves et al. (1998) conducted a meta-analysis in Hypertension (n=2,955). Irbesartan vs. Placebo was evaluated on Therapeutic response (trough seated diastolic blood pressure <90 mm Hg or a reduction from baseline of >= 10 mm Hg) and maximum reductions in trough and peak seated diastolic and systolic blood pressure (Placebo-subtracted reductions of ~8 mm Hg systolic and ~5 mm Hg diastolic). Irbesartan provided dose-dependent blood pressure lowering, with the 150 mg dose yielding placebo-subtracted reductions of ~8/5 mm Hg and a 56% favorable response rate.
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