Abstract
The effects of a new angiotensin receptor antagonist, eprosartan (200 or 300 mg b.i.d.) and enalapril (5–20 mg u.i.d.) on cough and blood pressure were compared in a 26-week, double-blind, randomised, parallel-group, multicentre, international study involving 528 patients with hypertension. Uptitration of doses was based on clinic blood pressure measurements during the first 12 weeks, after which hydrochlorothiazide (12.5–25 mg/day) could be added. The frequency and intensity of cough was assessed by a standardised questionnaire administered at each clinic visit. The primary end-point was the incidence of persistent, dry cough not due to upper respiratory infection; change in sitting diastolic blood pressure and overall incidence of cough were secondary end-points. During the first 12 weeks of double-blind therapy, enalapril treatment was associated with a 3.45-fold higher risk of definite cough (14/261 vs 4/259, P = 0.018). Overall cough incidence (from spontaneous reports from patients, or investigator’s observation) was also more frequent with enalapril, as compared to eprosartan. Both agents reduced blood pressure significantly compared to baseline, although the eprosartan-treated group had a slightly higher response rate (defined as sitting diastolic blood pressure <90 mm hg, or at least a 10 mm hg reduction from baseline), both at end of titration (70.3% vs 62.6%, P < 0.05) and after 26 weeks (81.7% vs 73.5%, P = 0.018). These data suggest that, in unselected hypertensive patients, eprosartan is associated with less cough and a somewhat higher responder rate than enalapril.
Similar content being viewed by others
Author information
Authors and Affiliations
Consortia
Rights and permissions
About this article
Cite this article
Elliott, W., for the Eprosartan Study Group. Double-blind comparison of eprosartan and enalapril on cough and blood pressure in unselected hypertensive patients. J Hum Hypertens 13, 413–417 (1999). https://doi.org/10.1038/sj.jhh.1000816
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jhh.1000816
- Springer Nature Limited
Keywords
This article is cited by
-
Diabetes and CVD risk during angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker treatment in hypertension: a study of 15 990 patients
Journal of Human Hypertension (2014)
-
Antihypertensive effects and safety of eprosartan: a meta-analysis of randomized controlled trials
European Journal of Clinical Pharmacology (2012)
-
Updated Report on Comparative Effectiveness of ACE inhibitors, ARBs, and Direct Renin Inhibitors for Patients with Essential Hypertension: Much More Data, Little New Information
Journal of General Internal Medicine (2012)
-
Ambulatory monitoring of systolic hypertension in the elderly: Eprosartan/hydrochlorothiazide compared with losartan/hydrochlorothiazide (INSIST trial)
Advances in Therapy (2010)
-
Efficacy of eprosartan in combination with HCTZ in patients with essential hypertension
Journal of Human Hypertension (2002)