Background: The primary objective of this study was to compare the change from baseline in mean diastolic ambulatory blood pressure (ABP) at 24h post dose (trough measurement) after 8 weeks of treatment with irbesartan or valsartan in subjects with mild-to-moderate hypertension. Secondary objectives included comparing the mean changes from baseline in systolic ABP at trough; 24-h ABP; morning and night-time ABP; self-measured systolic blood pressure (SBP) and diastolic blood pressure (DBP); and office-measured SBP and DBP at trough. Design: After a 3-week, single blind, placebo lead-in period, 426 subjects were randomized to receive either irbesartan 150 mg or valsartan 80 mg for 8 weeks. Methods: Ambulatory blood pressure measurements were obtained at baseline and at week 8. Self-measured morning and evening DBP and SBP readings were obtained at home over a 7-day period at baseline and at week 8. Office-measured seated DBP and SBP measurements were obtained at trough, at baseline, and at week 8. Results: Irbesartan demonstrated significantly greater reductions than valsartan for mean change from baseline in diastolic ABP at trough (-6.73 versus -4.84 mmHg, respectively; P=0.035). Irbesartan produced significantly greater reductions than valsartan for mean systolic ABP at trough (-11.62 versus -7.5 mmHg, respectively; P <0.01) and for mean 24-h diastolic ABP (-6.38 versus -4.82 mmHg, respectively; P=0.023) and systolic ABP (-10.24 versus -7.76mmHg; P <0.01). Irbesartan also produced significantly greater reductions than valsartan for office-measured seated DBP (-10.46 versus 7.28 mmHg, respectively; P <0.01) and SBP (-16.23 versus -9.96 mmHg, respectively; P <0.01) and for self-measured morning DBP (-6.28 versus -3.75 mmHg, respectively; P <0.01) and SBP (- 10.21 versus -6.97 mmHg, respectively; P <0.01). Both drugs were well tolerated. Conclusion: Irbesartan was more effective than valsartan in reducing DBP and SBP at trough and in providing greater overall 24-h blood pressure-lowering efficacy.
- Ambulatory blood pressure monitoring
- Angiotensin II receptor antagonists
ASJC Scopus subject areas
- Internal Medicine
- Cardiology and Cardiovascular Medicine