Author, Subjects, Keywords

Cited Author

 

 
   » By Author or Editor
 » Browse Author by Alphabet
 » By Journal
 » By Subjects
 » Malaysian Journals
 » By Type
 » By Year
 » By Latest Additions
 
 
   » By Author
 » Top 20 Authors
 » Top 20 Article
 » Top Journal Cited
 » Top Article Cited
 » Journal Citation Statistics
 » Usage Since Sept 2007


 
 
 

Login | Create Account

A Comparison of Valsartan and Perindopril in the Treatment of Essential Hypertension in the Malaysian Population

Bavanandan, S., and Morad Z., and Ismail O., and Chandran, A., and Thayaparan, T., and Singaraveloo, M., (2005) A Comparison of Valsartan and Perindopril in the Treatment of Essential Hypertension in the Malaysian Population. Medical Journal of Malaysia, 60 (2). pp. 158-162. ISSN 0300-5283

Full text not available from this repository.

Affiliations

Hospital Kuala Lumpur. Dept. of Nephrology.
Hospital Kuala Lumpur. Dept. of Nephrology.
Hospital Pulau Pinang. Dept. of Cardiology.
Hospital Ipoh. Dept. of Medicine.
Hospital Seremban. Dept. of Medicine.
Hospital Sultanah Aminah. Dept. of Medicine.

Abstract

This study was conducted to determine the safety, tolerability and efficacy of valsartan (DIOVAN®) compared to perindopril (COVERSYL®) in Malaysian patients with mild to moderate hypertension. Two hundred and fifty adult Malaysian patients with a mean sitting diastolic blood pressure of more than 95 mmHg and less than 115 mmHg after a 14 day washout period were randomized to receive either valsartan 80 mg once daily (n=125) or perindopril 4mg daily (n=125) for eight weeks. The primary end point for efficacy was the change in mean sitting systolic and diastolic blood pressure (SiSBP and SiDBP). The primaty criteria for evaluation of tolerability was the incidence Of adverse events. There were no significant differences between the two groups with respect to sex, age, Weight. baseline sitting and standing systolic and diastolic blood pressure. At 0, 4 and 8 weeks the mean SiDBP in the valsartan group were 101.4, 92.8 and 91.0 mmHg respectively. The corresponding BP for the perindopril treated group was 102.6, 93.3 and 93.2 mmHg. (95% CI -1.39 to +3.27). There were no significant differences in the mean BP measurements between the valsartan and perindopril group at 0, 4 and 8 weeks. In each group there were significant differences between the BP at 4 and 8 weeks compared to baseline. A similar pattern was seen with SiSBP. At 4 weeks 28.7% of the valsartan and 25% of the perindopril group had their BP normalized (SiDBP < 90 mmHg) The percentages of patients who responded (SiDBP reduction > 10 mmHg but SiDBP > 90 mmHg) were 21 .3 in the valsartan group and 20.8 in the perindopril group. At 8 weeks, 31.1% of the valsartan group and 30.8% of the perindopril group had their BP normalized. The response rate Was 27% and 22.5% for valsartan and perindopril respectively. The major adverse event was cough which occurred in 18 patients (14.4%) in the perindopril and 1 (0.8%) in the valsartan group at 4 weeks. At 8 weeks the figures were 24 (19.2%) and 2 (1.6%) respectively. The results indicate that Valsartan is safe and efficacious in the treatment of mild to moderate hypertension It is equally efficacious to Perindopril and not associated with any major adverse event. It has a better tolerability profile with respect to dry cough.

Item Type:Journal
Keywords:Hypertension, ACE Inhibitor, Angiotensin Receptor Blocker, Tolerability, Efficacy
Subjects:R Medicine, Dentistry, Pharmacy, Nursing
ID Code:5782

1. American Heart Association: 1999 Heart and Stroke Statistical Update. Dallas, Taxas, American Heart Association, 1998; 1-29.

2. Lim, T.O., Ding, L.M., Gob, B.L., Zaki M. et al. Distribution of Blood Pressure in a national sample of Malaysian adults. Medical Journal of Malaysia 2000; 55(1).

3. Flack JM, Neaton J, Grimm R Jr et al., for the Multiple Risk Factor Intervention Trial research Group. Blood pressure and mortality among mean with prior myocardial infarction. Circulation 1995; 92: 2437-445.

4. MacMahon S. Blood pressure and the prevention of stroke, J Hypertens 1996; 14 (suppl): S39-S46.

5. Collins R, MacMahon S. Blood pressure, antihypertensive drug treatment and the risks of stroke and coronary heart disease BMJ 1994; 50: 272-98.

6. Rodgers A, MacMahon S. Gamble G, Stattery J et al., for the United Kingdom Transient Ischaemic Attack Collaborative Group. Blood pressure and risks of stroke in patients with cerebrovascular disease BMJ 1996; 313: 147.

7. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. JAMA 2003; 289: 2560-572.

8. Burt VL, Culter JA, Higgins M et al. Trends in prevalence, awareness, treatment and control of hypertension. Hypertension 1995; 50: 272-98.

9. Jackson EK, Garrison JC. Renin and angiotensin. In: Goodman and Gilman’s pharmacological basis of therapeutics. 9th edition New York, NY : McGraw Hill: 1996: 733-58.

10. Goodfriend TL, Elliot ME, Calt KJ. Angiotensin receptors and their antagonists. N Eng J Med 1996; 334: 1649-654.

11. Bauker JH, Reams GP. Angiotensin II type 1 receptor antagonists: a new class of antihypertensive drugs. Arch Intern Med 1995; 155: 1361-368.

12. Mathew HW. Racial, ethnic and gender differences in response to medicines. Drug Metabolism and Drug Interactions 1995; 12: 77-91.

13. Weinshilboum R. Inheritance and Drug Response. N Engl J Med 2003; 348(6): 529-37.

14. Evans WE, McLeod HL . Pharmacogenomics - Drug Disposition, Drug Targets, and Side Effects. N Engl J Med 2003; 348(6): 538-49.

15. Lin HJ, Han C-Y, Lin BK, Hardy S. Slow acetylator mutations in human polymorphic N-acetyltransferase gene in 786 Asians, blacks, Hispanic, and whites: application to metabolic epidemiology. Am J Hum Genet 1993; 52: 827-34.

16. Subcommittee of WHO/ISH. Clin Exp Hypertens 1993; 15: 1363-395.

17. Oparil S, Dyke S, Harris F et al. Efficacy and Safety of Valsartan compared with placebo the treatment of patients with essential hypertension. Clin Ther 1996; 18(5): 797-810.

18. Holwerda NJ, Fogardi R, Angets P et al. Valsartan, a new angiotensin II antagonists for treatment of essential hypertension: efficacy and safety compared with placebo, and enalapril. J Hypertens 1996; 14: 1147-51.

19. Mallion JM, Boutelant S, Chabaux P et al. Valsartan blood pressure reduction in essential hypertension compared with enalapril. Blood Pressure Monitoring 1997; 2: 179-84.

20. Prabowo P, Arwanto A, Soemantri D, Sukardar E et al. A comparison of Valsartan and Captopril in patients with essential hypertension in Indonesia. Int J Clin Pract 1999; 53 (4): 268-72.

21. Zhou HH, Koshakji RP, Silberstein DJ et al . Racial differences in drug response: Altered sensitivity to and clearance of propranolol in men of Chinese descent as compared to American whites. N Engl J Med 1989; 320: 565-70.

22. Mclnnes GT. Clinical advantage of Valsartan. Cardiology 1999; 91 (Suppl 1): 14-1.

23. Hansson L, Zanchetti A et al. Effects of intensive blood pressure lowering and low dose aspirin in patients with hypertension (Hypertension Optimal Treatment (HOT) study). Lancet 1998; 351: 1755-762.

Repository Staff Only: item control page