Key result
Eprosartan reduced the composite of total mortality and all cardiovascular and cerebrovascular events by 21% compared to nitrendipine in hypertensive patients with a previous stroke.
Why the study?
Does eprosartan improve cardiovascular protection and prevent stroke in hypertensive patients compared to calcium channel blockers like nitrendipine?
Does eprosartan improve cardiovascular protection and prevent stroke in hypertensive patients compared to calcium channel blockers like nitrendipine?
Eprosartan may offer superior cardiovascular and cerebrovascular protection compared to calcium channel blockers in hypertensive patients, particularly for stroke prevention.
May support eprosartan preference over nitrendipine post-stroke; leaves open prospective confirmation in contemporary trials.
Hypertension is the most important cardiovascular risk factor for stroke. Blood pressure reduction by antihypertensive treatment is clearly efficacious in the prevention of stroke (both primary and secondary), although no clear differences have yet been observed between antihypertensive drug classes. However, a recent study reported the clear superiority of the angiotensin-receptor blocker eprosartan over the calcium channel blocker nitrendipine in cardiovascular protection of hypertensive patients with a previous stroke. Comparative studies using angiotensin-receptor blockers have also suggested the superiority of this class of drugs on primary stroke prevention. This effect may be linked to their beneficial actions on left ventricular hypertrophy, atrial enlargement, and supraventricular arrhythmias, endothelial dysfunction, inflammation, and remodelling, as well as a direct neuroprotective effect mediated through the stimulation of the angiotensin II type-2 receptor. In addition, a sympathoinhibition observed with the renin-angiotensin system blockers and particularly demonstrated with eprosartan, may help to explain the better cardiovascular and cerebrovascular protection in comparison with the calcium antagonist nitrendipine.
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Alejandro de la Sierra (2006) conducted a review in Hypertension with previous cerebrovascular event (n=1,405). Eprosartan vs. Nitrendipine 10 mg once daily was evaluated on Composite of total mortality and all cardiovascular and cerebrovascular events, including all recurrent events (21% risk reduction, 95% CI 4% to 34%, p=0.014). Eprosartan reduced the composite of total mortality and all cardiovascular and cerebrovascular events by 21% compared to nitrendipine in hypertensive patients with a previous stroke.
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