Source: Eur Urol  |  Posted 5 years ago

By Ed Susman

NEW YORK, N.Y. -- May 17, 2006 -- In a primary care setting, about 73% of patients being treated with the angiotensin-converting enzyme inhibitor trandolapril were able to reach their blood pressure goals, researchers said here at the 21st annual scientific meeting and exposition of the American Society of Hypertension (ASH).

"When you consider that in Canada just 13% of patients with high blood pressure are achieving their goal, this result from 193 family practices across Canada is pretty amazing," said Richard Tytus, MD, assistant clinical professor of medicine, McMaster University, Hamilton, Ontario, Canada.

"We actually were able to get 40% of our patients to goal on once-daily doses of trandolapril 1 mg, and were able to titrate other patients upwards," he said at his poster presentation May 17, 2006.

For their prospective, interventional, open-label, single cohort, multicenter study, Dr. Tytus and his colleagues enrolled 2,096 adult patients with stage 1 or stage 2 hypertension from physicians' offices throughout Canada. Patients were na?ve to hypertensive therapy (84% of patients) or had been receiving diuretics or calcium channel blocker therapy that was unable to control to their blood pressure.

A total of 1,683 patients completed the 14-week trandolapril dose optimization phase; 1,650 completed the protocol-defined 26 weeks of study. Patients continued their calcium channel blocker or diuretic therapy throughout the study. The trandolapril dose was titrated up to 4 mg trandolapril, if necessary.

"Statistically significant and clinically important decreases in blood pressure were observed as early as 4 weeks after beginning therapy, with the total population of the study achieving an average 16.1-mm Hg fall in systolic blood pressure and an average 8.8-mmHg fall in diastolic blood pressure." Dr. Tytus said. That difference from baseline reached statistical significance at the P =.001 level, he said.

The drug was well tolerated, with 6% of patients reporting cough, a common adverse event with ACE inhibitors. No angioedema was reported.

Dr. Tytus reported that 93.7% of patients said they were compliant in taking their medication as prescribed.

The phase 4 post-marketing study was supported by Abbott Laboratories, Montreal, Canada.

[Presentation title: TRAIL-The effectiveness of Trandolapril-based Treatment Regimen in Reaching Blood Pressure Goals: An Observational Study. Abstract 232C]