The angiotensin receptor blocker eprosartan mesylate reduces pulse pressure in isolated systolic hypertension.

BACKGROUND

Isolated systolic hypertension (ISH) is a common and particularly poorly controlled form of hypertension.

OBJECTIVE

To assess the effect of eprosartan 600 mg tablet once daily on blood pressure (BP), pulse pressure, BP response, compliance and safety in subjects with ISH compared with subjects with combined systolic-diastolic hypertension (non-ISH).

PATIENTS AND METHODS

The present study is a post hoc evaluation of a prospective, randomized, open-label, multicentre study. Subjects 60 to 84 years old with ISH (systolic BP 140 mmHg or greater with diastolic BP less than 90 mmHg) (n=97) or non-ISH (systolic BP 140 mmHg or greater with diastolic BP 90 mmHg or greater) (n=98) received 10 weeks of treatment with either eprosartan alone or eprosartan plus home BP monitoring.

RESULTS

Eprosartan significantly reduced systolic BP at the study end point from baseline in both the ISH group and the non-ISH group (-17.5+/-14.5 mmHg and -20.6+/-14.1 mmHg [mean +/- SD], respectively; P<0.0001). The reduction in diastolic BP was significantly greater in subjects with non-ISH than in those with ISH (-12.2+/-8.1 mmHg and -5.0+/-7.9 mmHg, respectively; P<0.0001). Mean pulse pressure was significantly reduced from baseline in both groups (P<0.0001), but was reduced to a significantly greater degree in the ISH group than in the non-ISH group (-12.5+/-12.3 mmHg and -8.4+/-11.1 mmHg, respectively; P<0.05). The most common adverse events were dizziness, headache and fatigue.

CONCLUSIONS

Eprosartan effectively lowered BP and pulse pressure in all subjects. The magnitude of pulse pressure reduction was significantly greater in the ISH group, and the diastolic BP reduction was greater in the non-ISH group, suggesting that eprosartan may be especially suitable in the treatment of subjects with ISH.