Key result
Continuation of initial antihypertensive monotherapy at 12 weeks was highest for ARAs and lowest for ACEIs, which also had the highest incidence of cough.
Why the study?
The short-term safety and tolerability of newly prescribed antihypertensive monotherapies in Korean patients were not well characterized.
How do different antihypertensive monotherapies compare regarding short-term safety and tolerability in Korean patients?
Observational (n=1,181)
How do different antihypertensive monotherapies compare regarding short-term safety and tolerability in Korean patients?
In Korean patients, ARAs have the highest short-term tolerability among antihypertensive monotherapies, while ACEIs have the lowest due to a high incidence of cough.
Answers are grounded in this paper and cite their sources.
May favor ARAs over ACEIs for short-term tolerability in Korean patients; hypothesis-generating for class selection pending randomized data.
PURPOSE: In order to assess the short-term safety and tolerability of newly prescribed antihypertensive monotherapies in Korean patients, a prospective study was carried out. METHODS: A total of 1181 patients were observed from July 1997 to August 1999. At 2, 4, 8 and 12 weeks after initiation of antihypertensive monotherapy, the patients were evaluated for whether treatment was to be continued and the development of any adverse reactions. RESULTS: During the first 12 weeks, the percentage of subjects continuing with their initial angiotensin converting enzyme inhibitors (ACEI) (40.7%) was substantially lower than that of subjects continuing with angiotensin II receptor antagonists (ARA) (66.2%), alpha-blockers (63.0%), calcium channel blockers (CCB) (61.3%), beta-blockers (55.8%), and diuretics (53.5%), respectively (P < 0.01). The following adverse reactions were detected: cough (7.5%), headache (6.1%), dizziness (3.9%), flushing (3.7%) and impotence (2.4%). Cough, headache, and flushing were more frequent in women, and impotence and loss of libido were more frequent in men (P < 0.05). The incidence of cough associated with ACEI (27.9%) was higher than that associated with the other classes of drugs (P < 0.01). CONCLUSIONS: The tolerability of antihypertensive medication was highest in Korean patients treated with ARAs, followed by CCBs, beta-blockers, diuretics, alpha-blockers, and ACEIs. The incidences of adverse reactions were different by sex, age and drug class.
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Kim et al. (2000) conducted an observational in Hypertension (n=1,181). Antihypertensive monotherapies vs. Between-class comparison was evaluated on Continuation of initial therapy at 12 weeks (p=< 0.01). Continuation of initial antihypertensive monotherapy at 12 weeks was highest for ARAs and lowest for ACEIs, which also had the highest incidence of cough.
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