What question did this study set out to answer?

To compare the antihypertensive efficacy, safety, and tolerability of a candesartan cilexetil/hydrochlorothiazide combination tablet versus a losartan/hydrochlorothiazide combination tablet in patients with primary hypertension insufficiently controlled by monotherapy.

January 1, 2000Blood PressureOpen Access

Efficacy and Tolerability of a Combination Tablet of Candesartan Cilexetil and Hydrochlorothiazide in Insufficiently Controlled Primary Hypertension - Comparison with a Combination of Losartan and Hydrochlorothiazide

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Why the study?

Does candesartan/HCT 16/12.5 mg improve blood pressure reduction compared to losartan/HCT 50/12.5 mg in patients with primary hypertension insufficiently controlled on monotherapy?

Population

299 men and women, aged 20-80 years, with mild-to-moderate primary hypertension insufficiently controlled on…

Comparison

Candesartan cilexetil/hydrochlorothiazide… vs Losartan/hydrochlorothiazide combination tablet…

Design

RCT, randomized, double-blind

Follow-up

12 weeks

Authors

HÖHUGUES MILON K. PETER ÖHMANAstraZeneca (Sweden)

Discussion

Member takes

Implication

Supports preferring candesartan/HCT over losartan/HCT for greater BP reduction; confirms differential ARB efficacy in fixed-dose combinations.

Key Points

To compare the antihypertensive efficacy, safety, and tolerability of a candesartan cilexetil/hydrochlorothiazide combination tablet versus a losartan/hydrochlorothiazide combination tablet in patients with primary hypertension insufficiently controlled by monotherapy.
Randomized, double-blind trial enrolling 340 patients (mean age 59.5 years; sitting DBP 90–110 mmHg, SBP ≤ 200 mmHg) with primary hypertension insufficiently controlled after ≥4 weeks of antihypertensive monotherapy.
A total of 299 patients were randomized to receive once-daily candesartan/HCT (16/12.5 mg; n = 151) or losartan/HCT (50/12.5 mg; n = 148) for 12 weeks, with blood pressure measured 24 hours post-dose.
Candesartan/HCT produced significantly greater reductions than losartan/HCT in sitting DBP (-10.4 mmHg [95% CI, -11.8 to -8.9] vs -7.8 mmHg [95% CI, -9.3 to -6.3]; difference -2.6 mmHg [95% CI, -4.7 to -0.5]; p = 0.016) and SBP (-19.4 mmHg [95% CI, -22.1 to -16.7] vs -13.7 mmHg [95% CI, -16.5 to -10.9]; difference -5.7 mmHg [95% CI, -9.6 to -1.8]; p = 0.004).
A significantly higher proportion of patients achieved target DBP ≤ 90 mmHg with candesartan/HCT compared to losartan/HCT (60.9% [95% CI, 53.1 to 68.7] vs 49.3% [95% CI, 41.3 to 57.4]; p = 0.044).
Study withdrawals occurred in 12 patients (8 due to adverse events) receiving candesartan/HCT and 17 patients (12 due to adverse events) receiving losartan/HCT.

Structured PICO

Does candesartan/HCT 16/12.5 mg improve blood pressure reduction compared to losartan/HCT 50/12.5 mg in patients with primary hypertension insufficiently controlled on monotherapy?

Population

299 men and women, aged 20-80 years (mean age 59.5), with mild-to-moderate primary hypertension insufficiently controlled on previous monotherapy (sitting DBP ≥90 and ≤110 mmHg and sitting SBP ≤200 mmHg during treatment with any antihypertensive monotherapy for at least 4 weeks).

Intervention

Candesartan cilexetil/hydrochlorothiazide (candesartan/HCT; 16/12.5 mg) combination tablet once daily for 12 weeks

Comparator

Losartan/hydrochlorothiazide (losartan/HCT; 50/12.5 mg) combination tablet once daily for 12 weeks

Outcome

Reduction in sitting diastolic and systolic blood pressure at 12 weekssurrogate

A combination of candesartan/HCT 16/12.5 mg provides significantly greater blood pressure reduction than losartan/HCT 50/12.5 mg in patients with primary hypertension uncontrolled on monotherapy.

Cite This Study

HUGUES MILON K. PETER ÖHMAN (2000) studied this question.

synapsesocial.com/papers/6a7c19354e26224dc1ed1fe2 https://doi.org/10.1080/080370500439100

Topics

Hypertension management

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Implication

Supports preferring candesartan/HCT over losartan/HCT for greater BP reduction; confirms differential ARB efficacy in fixed-dose combinations.

Efficacy and Tolerability of a Combination Tablet of Candesartan Cilexetil and Hydrochlorothiazide in Insufficiently Controlled Primary Hypertension - Comparison with a Combination of Losartan and Hydrochlorothiazide

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Efficacy and Tolerability of a Combination Tablet of Candesartan Cilexetil and Hydrochlorothiazide in Insufficiently Controlled Primary Hypertension - Comparison with a Combination of Losartan and Hydrochlorothiazide

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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