Cost-benefit effectiveness of angiotensin-II receptor blockers in patients with uncomplicated hypertension: A comparative analysis

Abstract

Objective The treatment of hypertensive patients (HTs) requires a long-term commitment of compliance for the patient and resources by the healthcare system. This poses an economic dilemma in countries where universal healthcare is standard. The aim of this study was to evaluate the costs/health benefit and effectiveness of treatment with angiotensin-II receptor blockers (ARBs) in uncomplicated essential hypertension. Design and methods The daily and annual economic commitment for treating patients with ARBs was estimated using pharmacy dispensing records and the BP-lowering effects of candesartan, irbesartan, losartan, olmesartan, telmisartan and valsartan was evaluated retrospectively. In 114 HTs (mean age 59.4 ± 13.5 year, 57.5% men), the BP-lowering effect of ARBs as in monotherapy and in fixed-dose combination (FDC) with hydrochlorothiazide at the doses commonly used in the market to reach BP control (i.e. BP <140/90 mmHg) was analyzed. The BP lowering-effect was evaluated after an average of 6-month follow-up consulting medical professionals. Analysis of variance for repeated measures was provided. Results Treatment with candesartan (14.1%) and olmesartan (32,4%) versus other ARBs resulted in a significant decrease in BP as for mono- than for FDC therapy. Our studies suggest that daily (data not shown) and annual costs of olmesartan were higher than candesartan as in mono- (4577.71 ± 1120.55 vs. 894.25 ± 127.75 €) than for FDC therapy (5715.90 ± 459.90 vs. 1580.45 ± 113.15 €). Conclusions Treatment: of BP with candesartan appears to be the most favorable option in terms of cost-effectiveness coupled with favorable health outcomes. These data have some limitations, but open the question if candesartan should be preferred to olmesartan in BP management. Further prospective studies comparing ARBs based on their effect on BP control in uncomplicated HTs are needed for validation

Casein Hydrolysates by Lactobacillus brevis and Lactococcus lactis Proteases: Peptide Profile Discriminates Strain-Dependent Enzyme Specificity

“…In some cases, lactic fermentation is assisted by the addition of commercial enzymatic preparations 12,13 . 4 Arterial hypertension affects approximately 25% of the adult population worldwide and is predicted to reach 29% of the population by 2025 14,15 . Due to this high prevalence, food components, such as food peptides, with lowering blood pressure properties are receiving special attention.…”

“…12,13 Arterial hypertension affects approximately 25% of the adult population worldwide and is predicted to reach 29% of the population by 2025. 14,15 Because of this high prevalence, food components, such as food peptides, with lowering blood pressure properties are receiving special attention. Angiotensin converting enzyme (ACE, EC3.4.15.1) plays an important role in the regulation of arterial pressure because it catalyzes the conversion of angiotensin-I (the inactive form) to angiotensin-II (a vasoconstrictor) and inactivates bradykinin (a vasodilator).…”

Cost Effectiveness Analysis of Candesartan Therapy in Comparison to Candesartan-Amlodipine Therapy on Hypertensive Outpatients

“…The treatment of hypertensive patients (HTs) requires a long-term commitment of compliance for the patient and resources by the healthcare system. This poses an economic dilemma in countries where universal healthcare is standard [2] Candesartan is an angiotensin II receptor antagonist antihypertensive drug with a biphenyl derivative molecular structure. The active mechanism of candesartan inhibits the renin-angiotensinaldosterone system (RAAS) at level 1 of the angiotensin receptor (AT 1) for angiotensin II (AT II).…”