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Comparative efficacy of valsartan and olmesartan in mild-to-moderate hypertension: Results of 24-hour ambulatory blood pressure monitoring

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Abstract

The aim of this prospective, randomized, open-label, blinded endpoint (PROBE) study was to compare the antihypertensive efficacy of 2 angiotensin II (AII) receptor antagonists with different pharmacologic profiles, valsartan and olmesartan, in patients with mild-to-moderate essential hypertension. After an initial 2-week washout period, 114 patients (64 men, 50 women; aged 35–70 years) were randomly assigned to receive valsartan 160 mg or olmesartan 20 mg once daily for 8 weeks. After the washout period and after 2 and 8 weeks of treatment, 24-hour ambulatory blood pressure monitoring (ABPM) was performed using a noninvasive device, and casual blood pressure (BP) and heart rate were measured. Both olmesartan and valsartan had a clear-cut antihypertensive effect. However, significantly earlier and more pronounced antihypertensive activity was achieved with valsartan than with olmesartan, as demonstrated by (1) significantly lower 24-hour, daytime, and nighttime ABPM values after 2 weeks with valsartan (P < .01); (2) significantly lower percentage of abnormal BP readings with valsartan; (3) significantly higher trough-peak ratio and smoothness index with valsartan, suggesting a more prolonged and homogeneous antihypertensive effect; and (4) lower 24-hour postdose clinic systolic and diastolic BP values versus olmesartan. These findings show that pharmacodynamic and pharmacokinetic differences between All receptor antagonists, at clinically comparable dosages, may be associated with differences in anti hypertensive efficacy.

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Authors and Affiliations

  1. Divisione di Medicina Interna, Centro per la Diagnosi e Cura dell’Ipertensione Arteriosa, Ospedale Arnaboldi Via Emilia, 354, 27043, Broni (PV), Italy

    Maurizio Destro MD & Rossana Scabrosetti MD

  2. Dipartimento di Medicina Interna eTerapia Medica Centro dell’Ipertensione e Fisiopatologia Cardiovascolare Clinica Medica II, University of Pavia, Pavia, Italy

    Alessandro Vanasia Dr Eng & Amedeo Mugellini MD

Authors
  1. Maurizio Destro MD
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  2. Rossana Scabrosetti MD
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  3. Alessandro Vanasia Dr Eng
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  4. Amedeo Mugellini MD
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Destro, M., Scabrosetti, R., Vanasia, A. et al. Comparative efficacy of valsartan and olmesartan in mild-to-moderate hypertension: Results of 24-hour ambulatory blood pressure monitoring. Adv Therapy 22, 32–43 (2005). https://doi.org/10.1007/BF02850182

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