Dose-response efficacy of valsartan, a new angiotensin II receptor blocker

Pool, James L.; Glazer, Robert; Chiang, Yann Tong; Gatlin, M. M.

doi:10.1038/sj.jhh.1000788

Cited by 56 publications

(32 citation statements)

References 11 publications

(16 reference statements)

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“…Antihypertensive efficacy of valsartan has been established over a range of doses, up to 320 mg/day, in North American and European hypertensive patient populations (7,8,18). The results of the present study demonstrated the antihypertensive efficacy of once-daily 160 mg valsartan in Chinese patients with mild to moderate hypertension.…”

Section: Discussionsupporting

confidence: 54%

“…Valsartan is widely used alone and in combination with other antihypertensive drugs (6). Dose-dependent antihypertensive efficacy has been demonstrated for valsartan at doses up to 320 mg, with 80 or 160 mg as the recommended starting dose in Europe and North America (7,8). The antihypertensive efficacy of 160 mg valsartan has been demonstrated in several large controlled clinical trials, including VALUE and NAVIGATOR (9,10).…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and tolerability of once-daily 160 mg valsartan in Chinese patients with mild to moderate hypertension

Sun

Yang

Gao

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. The present multicentre, prospective, open-label, single treatment arm study (Val-Perfect) examined the efficacy and tolerability of once-daily valsartan monotherapy (80 mg for two weeks, followed by 160 mg for eight weeks) in 195 Chinese patients with mild to moderate hypertension, using office, home, and ambulatory blood pressure (BP) monitoring. Significant mean reductions (P<0.0001) were observed in office BP from baseline to week 10, with mean sitting systolic BP (MSSBP) and mean sitting diastolic BP (MSDBP) values of 15.6±12.3 and 11.1±8.6 mmHg, respectively. The office BP control rate at week 10 was 56.9% (target MSSBP/MSDBP <130/80 mmHg for patients with type 2 diabetes or chronic kidney disease, <140/90 mmHg for others). Valsartan treatment significantly reduced mean 24-h SBP/DBP (-6.1/-4.4 mmHg; both P<0.0001) and mean home-monitored SBP/DBP (-13.3/-9.1 mmHg; both P<0.0001) at week 10. The incidence of adverse events (AEs) leading to discontinuation (1.5%) or drug-related AEs (3.1%) was low, with no instances of mortality or drug-related serious AEs. These results indicate that 160 mg valsartan is safe and effective at lowering BP in Chinese patients with mild to moderate hypertension. The significant reductions in office-based and out-of-office BP measures support the clinical relevance of moderate-dose valsartan monotherapy for effective 24-h BP control.

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Efficacy and tolerability of once-daily 160 mg valsartan in Chinese patients with mild to moderate hypertension

Sun

Yang

Gao

et al. 2017

Experimental and Therapeutic Medicine

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“…From studies in patients with moderate-tosevere essential hypertension, no evidence of an additional antihypertensive effect of doses of captopril up to 600 mg or enalapril/benazepril up to 80 mg (33)(34)(35)(36) exists. Increasing the dose of valsartan from 80 to 160 mg resulted in an additional drop in systolic and diastolic BP of Ͻ 1 mmHg in mild-to-moderate hypertension (37). Consequently, our findings of an additive effect on albuminuria and BP suggest a more complete blockade of the RAS when using both ACE-I and ARB.…”

Section: Discussionmentioning

confidence: 51%

Additive Effect of ACE Inhibition and Angiotensin II Receptor Blockade in Type I Diabetic Patients with Diabetic Nephropathy

Jacobsen¹,

Andersen²,

Jensen³

et al. 2003

Journal of the American Society of Nephrology

194

146

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Abstract. Albuminuria and hypertension are predictors of poor renal and cardiovascular outcome in diabetic patients. This study tested whether dual blockade of the renin-angiotensin system (RAS) with both an angiotensin-converting enzyme (ACE) inhibitor (ACE-I) and an Angiotensin-II receptor blocker (ARB) is superior to either drug alone in type I diabetic patients with diabetic nephropathy (DN). A randomized double-blind crossover trial was performed with 8-wk treatment with placebo, 20 mg of benazepril once daily, 80 mg of valsartan once daily, and the combination of 20 mg of benazepril and 80 mg of valsartan. Twenty type I diabetic patients with DN were included. At the end of each treatment period, albuminuria, 24-h BP, and GFR were measured. Eighteen patients completed the study. Placebo values were: albuminuria [mean (95% CI)], 701 (490 to 1002) mg/24 h; BP [mean (SEM)], 144 (4)/79 (2) mmHg, and GFR [mean (SEM)], 82 (7) ml/min per 1.73 m 2 . Treatment with benazepril, valsartan, or dual blockade significantly reduced albuminuria and BP compared with placebo. Benazepril and valsartan were equally effective. Dual blockade induced an additional reduction in albuminuria of 43 % (29 to 54 %) compared with any type of monotherapy, and a reduction in systolic BP of 6 (0 to 13) mmHg and 7 (1 to 14) mmHg (versus benazepril and valsartan, respectively) and a reduction of 7 (4 to 10) mmHg diastolic compared with both monotherapies. GFR was reversibly reduced on dual blockade compared with monotherapy and placebo. All treatments were safe and well tolerated. In conclusion, dual blockade of the RAS may offer additional renal and cardiovascular protection in type I diabetic patients with DN.Albuminuria and hypertension are predictors of poor renal and cardiovascular outcome in patients with diabetes (1,2). Antihypertensive treatment, especially ACE-I, has been shown to reduce albuminuria, to diminish loss of kidney function, and to improve survival in type I patients with DN (1-3). Studies of diabetic and nondiabetic kidney disease suggest the initial degree of reduction in albuminuria after blockade of the reninangiotensin system (RAS) predicts an attenuated rate of decline in GFR, as reviewed by Rossing (1). As a consequence, albuminuria may serve as a surrogate end point for monitoring treatment efficacy and prognosis in DN (4).A superior effect on BP and a tendency toward a more pronounced drop in urinary albumin excretion of dual blockade of the RAS compared with single blockade has been reported in type II patients with microalbuminuria (5). We have recently shown additional drop in albuminuria and diastolic BP when adding an angiotensin receptor blocker (ARB) to angiotensinconverting enzyme inhibitor (ACE-I) treatment in type l patients with albuminuria Ͼ1 g/24 h and BP Ͼ135/85 mmHg, despite conventional antihypertensive therapy including three different agents (6). However, this subgroup is highly selected; therefore, it may differ from the patients in general with DN, especially with regard to RAS activity and ...

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“…9 Valsartan is well tolerated and is not associated with the adverse effects that limit the use of ACE inhibitors. 9,18,19 Amlodipine was selected as the comparator because it is a first-line antihypertensive agent in blacks, in part because of guideline recommendations suggesting that these patients respond better to calcium antagonists and diuretics than to other classes of antihypertensive agents. 1 The maximum recommended dose of amlodipine, which is not uncommonly associated with pedal edema, often is required to control BP in black patients.…”

mentioning

confidence: 99%

A Noninferiority Comparison of Valsartan/Hydrochlorothiazide Combination Versus Amlodipine in Black Hypertensives

et al. 2005

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Abstract-The objective of the study was to demonstrate that reduction in mean 24-hour diastolic blood pressure with 160 mg valsartan and 12.5 mg hydrochlorothiazide was not inferior to 10 mg amlodipine in hypertensive blacks. A total of 482 blacks with stage 1 and stage 2 hypertension (mean seated blood pressure 140 to 180/90 to 110 mm Hg) were enrolled in a double-blind, randomized, prospective study. After a placebo run-in period, patients were randomized to 160 mg valsartan or 5 mg amlodipine for 2 weeks, then force-titrated to 160 mg valsartan and 12.5 mg hydrochlorothiazide or 10 mg amlodipine for an additional 10 weeks.

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Dose-response efficacy of valsartan, a new angiotensin II receptor blocker

Cited by 56 publications

References 11 publications

Efficacy and tolerability of once-daily 160 mg valsartan in Chinese patients with mild to moderate hypertension

Efficacy and tolerability of once-daily 160 mg valsartan in Chinese patients with mild to moderate hypertension

Additive Effect of ACE Inhibition and Angiotensin II Receptor Blockade in Type I Diabetic Patients with Diabetic Nephropathy

A Noninferiority Comparison of Valsartan/Hydrochlorothiazide Combination Versus Amlodipine in Black Hypertensives

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