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Eplerenone Superior To Losartan In Black Patients With Hypertension
A DGReview of :"Efficacy and tolerability of eplerenone and losartan in hypertensive black and white patients"
Journal of the American College of Cardiology (JACC)
04/14/2003
By James Adams
Antihypertensive effects of eplerenone are superior to those of losartan in black patients with hypertension, say researchers.
The effect of eplerenone is similar between black and white patients, but losartan has a lesser effect in black patients than in white patients, report the investigators, from the Department of Internal Medicine at Wayne State University in Detroit, Michigan, United States.
Essential hypertension and cardiovascular-renal-target organ damage is more prevalent in black than white adults in the United States, the investigators explain. They compared the effects of eplerenone, losartan and placebo in 348 black and 203 white patients with mild-to-moderate hypertension.
The patients were randomised to receive one of the three treatments in a double-blind study. Dosage was 50 milligrams per day for both eplerenone and losartan.
In all patients combined, mean diastolic blood pressure was reduced 5.3 ± 0.7 mm Hg by placebo, 10.3 ± 0.7 mm Hg by eplerenone and 6.9 ± 0.6 mm Hg by losartan after 16 weeks of treatment.
Black patients showed a decrease in mean diastolic blood pressure of 4.8 ± 1.0 mm Hg with placebo, 10.2 ± 0.9 mm Hg with eplerenone and only 6.0 ± 0.9 with losartan.
Mean diastolic blood pressure in white patients was reduced by 6.4 ± 1.0 mm Hg, 11.1 ± 1.1 mm Hg and 8.4 mm Hg with placebo, eplerenone and losartan, respectively.
Eplerenone was also superior to placebo and losartan for reducing systolic blood pressure in all patients combined and in black patients. It was superior to placebo, but not losartan, in white patients.
Eplerenone was also more effective than losartan at reducing systolic and diastolic blood pressure in low renin patients. It was at least as effective as losartan in patients with differing levels of baseline aldosterone.
Both eplerenone and losartan were well tolerated.
J Am Coll Cardiol 2003;41:7:1148-1155.
"Efficacy and tolerability of eplerenone and losartan in hypertensive black and white patients"
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