Angiotensin II Antagonists

Overview of efficacy with eprosartan in essential hypertension

Eprosartan has been evaluated in several controlled clinical studies in patients with all grades of essential hypertension. Table 1 gives an overview of the key efficacy studies which are reviewed on the following pages. The studies by Sega, Ruilope, Punzi and Teitelbaum highlight the efficacy of eprosartan in controlling raised systolic blood pressure. Efficacy in the secondary prevention of stroke and renoprotection appear later.

Table 1: Overview of some key efficacy studies with eprosartan

Principal Author Year Comparator Key points
Sega 1999 enalapril Severe hypertension: Eprosartan had a statistically significantly greater effect than enalapril on both sitting and standing systolic blood pressure (p=0.025)
Ruilope 2001 enalapril Eprosartan was effective in elderly patients with predominantly systolic hypertension
Punzi 2004 placebo Eprosartan was statistically significantly more effective than placebo in reducing sitSBP, either as monotherapy (p<0.0001) or in combination with HCTZ (p<0.002)
Teitelbaum 2004 open label Eprosartan significantly reducing SBP in patients with ISH, either as monotherapy or in combination with HCTZ (p<0.0001). The reduction in DBP was significantly greater in patients with combined systolic-diastolic hypertension than in those with ISH (p<0.0001) (indicating a preferential effect on SBP in patients with ISH)
de la Sierra 2004 open label Eprosartan significantly reduced pulse pressure at 12 weeks (p<0.001 versus baseline) and reduced the ratio of pulse pressure/mean arterial pressure. In a subgroup analysis it had a predominant effect on SBP in patients with ISH
Robles 2005 open label Eprosartan significantly reduced pulse pressure, SBP, DBP and mean arterial pressure (all p<0.0001 versus baseline); it significantly reduced the ratio of pulse pressure/mean arterial pressure
Elliott 1999 enalapril Eprosartan and enalapril were equally effective in mild-moderate hypertension. When used in combination with HCTZ, there was a statistically significantly greater response with the eprosartan-based regimen than with the enalapril-based regimen (p=0.018)
Oparil 1999 enalapril & placebo Eprosartan and enalapril were statistically significantly more effective than placebo (p<0.002 and p<0.035, respectively) in patients with mild-to-moderate essential hypertension
Puig 1999 losartan Eprosartan and enalapril were statistically significantly more effective than placebo (p<0.002 and p<0.035, respectively) in patients with mild-to-moderate essential hypertension
Hedner 1999 placebo Eprosartan was statistically significantly more effective than placebo (p=0.05) in patients with mild-to-moderate essential hypertension; a once-daily dose was as effective as a twice daily dose
Gradman 1999 placebo Eprosartan was statistically significantly more effective than placebo (p<0.0001) in patients with mild-to-moderate essential hypertension
Argenziano 1999 enalapril Responses to eprosartan in the elderly were similar to those in a younger age group
Levine 1999 enalapril Response rates with eprosartan were statistically significantly higher than with enalapril in black patients, either as monotherapy (p<0.05) or in combination with HCTZ (p<0.018)
Levine 2001 long-term (open) Reductions in sitSBP seen during the titration phase were maintained during long-term treatment
Sachse 2002 combination with HCTZ Combining HCTZ with eprosartan gave additional statistically significant improvements in terms of sitSBP (p=0.01), sitDBP (p=0.001) and response rate (p=0.004)

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