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| Original Article |
| A forced titration study of antihypertensive efficacy of candesartan cilexetil in comparison to losartan: CLAIM Study II |
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| D G Vidt1, W B White2, E Ridley3, M Rahman4, S Harris5, J Vendetti5, E L Michelson5 and R Wang5 and CLAIM Study investigatorsb |
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1Cleveland Clinic Foundation, Cleveland, OH, USA
2Section of Hypertension and Clinical Pharmacology, University of Connecticut Health Center, Farmington, CT, USA
3Medical College of Virginia Commonwealth University, Richmond, VA, USA
4Case Western Reserve University, Cleveland, OH, USA
5AstraZeneca LP, Chesterbrook, PA, USA
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Correspondence to: Dr Donald Vidt, Cleveland Clinic Foundation, Department of Hypertension and Nephrology, A-51, 9500 Euclid Avenue, Cleveland, OH 44195, USA. E-mail: vidtd@ccf.org
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Supported by a grant from AstraZeneca LP, Wayne, PA, USA bSee Appendix |
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| Abstract |
| An 8-week, multicentre (72 sites in the US), double-blind, randomised, parallel group, forced titration study compared the antihypertensive efficacy of candesartan cilexetil and losartan. A total of 611 patients with essential hypertension (diastolic blood pressure 95 to 114 mm Hg) were randomised initially to candesartan cilexetil 16 mg once daily or losartan 50 mg once daily. After 2 weeks of randomised treatment, the doses of candesartan cilexetil and losartan were doubled to 32 mg and 100 mg once daily and continued respectively for 6 weeks. At week 8, candesartan cilexetil lowered the blood pressure (BP) at 24 h (trough), 6 h (peak) and 48 h post dose to a significantly greater extent (P < 0.05) than losartan: candesartan cilexetil lowered trough BP by 13.4/10.5 mm Hg, peak BP by 15.5/12.9 mm Hg and 48-h BP by 10.5/9.9 mm Hg compared to a reduction of trough BP by 10.1/9.1 mm Hg, peak BP by 12.0/9.5 mm Hg, and 48-h BP by 5.9/7.0 mm Hg by losartan. The responder and control rates were numerically higher in the candesartan cilexetil group, but the differences did not reach statistical significance; the responder rates were 58.8% for the candesartan cilexetil group and 52.1% for the losartan group and control rates were 49.0% for the candesartan cilexetil group and 44.6% for the losartan group. Overall, both treatment regimens were well tolerated. A total of 15 of the 611 (2.5%) patients withdrew from the study due to an adverse event, including nine (2.9%) in the candesartan cilexetil group and six (2.0%) in the losartan group. In conclusion, this forced titration study confirms that candesartan cilexetil is more effective in lowering BP than losartan when compared at once daily maximum doses. Journal of Human Hypertension (2001) 15, 475-480 |
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| Keywords |
| candesartan cilexetil; losartan; CLAIM Study II |
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| Received 24 October 2000; revised 18 December 2000; accepted 9 February 2001 |
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| July 2001, Volume 15, Number 7, Pages 475-480 |
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