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Hypertension
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my personal edition > hypertension > news
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DGNews
Atacand (Candesartan Cilexetil) Appears More Effective Than Cozaar (Losartan) at Lowering Blood Pressure
MISSISSAUGA, ON -- May 10, 2004 -- The twenty-two per cent of adult Canadians who suffer from high blood pressure may be affected by recently approved changes to a product monograph. AstraZeneca Canada announced that the product monograph for Atacand® (candesartan cilexetil), an angiotensin II receptor blocker (ARB), has been approved to include a unique statement regarding its efficacy at lowering blood pressure over the widely used ARB, Cozaar® (losartan). Atacand is the first and only ARB to receive this type of recognition.
For approximately five million Canadians the recommended target blood pressure of less than 140/90 mm Hg is an elusive goal. Several published head-to-head studies support the monograph update and open the door to better hypertension management.
"Head-to-head studies are critical to helping physicians differentiate between products within the same class," says Dr. Robert Ting, Nephrologist, Scarborough Regional Dialysis Program. The CLAIM studies and others that were used to support the Atacand product monograph update, clearly show that Atacand is more effective than losartan at lowering blood pressure. As a physician, this data makes my choice of therapy clear and I can feel confident I am providing my patient with the best therapy."
The monograph revision process was initiated when the Canadian Hypertension Education Program changed the hypertension management guidelines to include angiotensin II receptor blockers (ARBs) as first-line therapy.
"Our understanding of the effectiveness of ARBs in lowering high blood pressure has grown considerably in recent years," says Dr. Norm Campbell, Professor of Medicine, University of Calgary and a member of the Canadian Hypertension Education Program steering committee. "We now know they are effective in reducing adverse cardiovascular events in hypertensive patients and in some cases offer additional therapeutic benefits. The addition of ARBs to the cadre of first-line therapies provides physicians with new options for treatment".
About Atacand
o Atacand is indicated for the treatment of mild to moderate essential hypertension and can be used as first-line treatment for systolic-diastolic hypertension, and isolated systolic hypertension.
o Unlike other ARBs, Atacand has been shown to deliver sustained blood pressure control for up to 48 hours. The differences between Atacand and losartan are most likely attributable to tighter binding and slower dissociation from the AT1-receptor with Atacand.
o The new Atacand product monograph states: "The antihypertensive efficacy of candesartan cilexetil and losartan potassium were compared at their approved once daily maximum doses... in patients with mild to moderate essential hypertension. Candesartan was shown to lower systolic and diastolic blood pressure by 2 to 3 mm Hg on average more than losartan potassium when measured at the time of either peak or trough effect." The study demonstrated that this difference in blood pressure control is clinically meaningful.1
About BP Control
o Approximately 22 per cent of Canadian adults suffer from high blood pressure.
o It is estimated that more than 70 per cent of hypertensives are left with uncontrolled (or no treatment at all) high blood pressure.
o Untreated, high blood pressure has serious and potentially fatal consequences, as it is a major risk factor for cardiovascular disease, stroke and kidney disease.2
o Uncontrolled high blood pressure increases the risk of chronic heart failure by 200 per cent, compared with those who do not suffer from hypertension.
o High blood pressure also represents a serious health problem among Canadian seniors. According to the Heart and Stroke Foundation, over half (57 per cent) of Canadian seniors have high blood pressure.
o Only 15 per cent of Canadian seniors with high blood pressure are receiving treatment and have their blood pressure under control.7
References:
1 Gradman AH et al. Comparative effects of candesartan cilexetil and losartan in patients with systemic hypertension. Heart Disease 1999; 1(2): 52-57
2 Hypertension and Economic Burden of Illnesses in Canada. Submitted to the Laboratory Centre for Disease Control by the Institute of Health Economics. 2000
3 The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. 2003. Available online: www.nhlbi.nih.gov/guidelines/hypertension/express.pdf
4 Lacourcière, Y., Asmar, R. A Comparison of the Efficacy and Duration of Action of Candesartan Cilexetil and Losartan as Assessed by Clinic and Ambulatory Blood Pressure After a Missed Dose, in Truly Hypertensive Patients. American Journal of Hypertension 1999; 12(12):1181-1187
5 Guidelines Subcommittee. 1999 World Health Organization - International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens 1999; 17(2):151-183
6 National Heart, Lung, and Blood Institute. Facts about heart failure. Available online: http://www.nhlbi.nih.gov/health/public/heart/other/hrtfail.htm
7 Heart and Stroke Foundation of Canada. General Blood Pressure Information. 2003
SOURCE: AstraZeneca Canada Inc.
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