Losartan potassium lowers blood pressure measured by ambulatory blood pressure monitoring

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Objectives:To determine the blood pressure lowering effect and safety of losartan potassium 50 mg once or twice daily, or l00mg once daily, using 24-h ambulatory blood pressure monitoring and conventional trough clinic blood pressureDesign:Multicenter, double-blind, randomized, parallel, placebo-controlled trialSetting:Nine sites in university hospitals and urban centers in the United StatesPatients:122 mild to moderate hypertensive adult non-black men and women, 21 years of age and older, who were within 30% of their ideal body weightIntervention:Qualification required a mean 24-h ambulatory blood pressure measurement of >85 mmHg and a sitting diastolic blood pressure of 95–115 mmHg. Subjects were then randomized to placebo or losartan potassium in three different dose regimensClinic blood pressure evaluations:Trough blood pressure was measured by trained observers using standardized methods, and ambulatory blood pressure measurements were obtained for 26 h using a SpaceLabs Model 90207 monitorResults:All doses of losartan potassium significantly decreased mean systolic 24-h ambulatory blood pressure (range –9.4 to –14.2 mmHg; P<0.01) and mean diastolic 24-h ambulatory blood pressure (range –5.6 to –9.0 mmHg; P<0.01) compared with placebo. All decreases were significantly different from placebo. The 24-h blood pressure profiles revealed a smooth, sustained antihypertensive effect of losartan potassium at all doses. Similar reductions in blood pressure were observed using trough clinic measurements. There were no significant differences in overall clinical adverse experiences between treatment groups. There were no significant changes in heart rate, body weight, electrocardiograms or mean laboratory measurementsConclusions:Losartan potassium, the first of a new class of potent and specific AT1-selective, non-peptide, angiotensin II antagonists, significantly reduces mean 24-h ambulatory blood pressure and trough clinic sitting blood pressure, and is well tolerated

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