Korean J Intern Med.  2017 Nov;32(6):1025-1036. 10.3904/kjim.2016.094.

24-Hour blood pressure response to lower dose (30 mg) fimasartan in Korean patients with mild to moderate essential hypertension

Affiliations
  • 1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. ohbhmed@snu.ac.kr
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 3Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
  • 5Department of Internal Medicine, The Heart Center of Chonnam National University Hospital, Gwangju, Korea.
  • 6Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.

Abstract

BACKGROUND/AIMS
Fimasartan is an angiotensin type 1 receptor blocker (ARB) which has comparable efficacy and tolerability with other ARBs. The aim of this study was to evaluate 24-hour blood pressure (BP) lowering efficacy and the tolerability of the low dose fimasartan compared with valsartan in patients with mild to moderate hypertension.
METHODS
This study was a phase II, prospective, multicenter, randomized, double-blind, parallel-grouped trial. A total of 75 hypertensive patients, whose mean ambulatory BP monitoring values were ≥ 135/85 mmHg, were randomized to either fimasartan 30 mg or valsartan 80 mg daily. The primary efficacy endpoint was the change in the mean 24-hour systolic BP (SBP) values from the baseline and at the week 8. Secondary endpoints included the change in the mean 24-hour diastolic BP values, the daytime and the nighttime mean BP values at week 8, the trough-to-peak (T/P) ratio and the smoothness index.
RESULTS
At week 8, the mean 24-hour SBP values significantly decreased in both groups; -10.5 ± 11.9 mmHg (p < 0.0001) in the fimasartan group and -5.5 ± 11.6 mmHg (p = 0.0307) in the valsartan group. The difference between two groups was 4.3 ± 2.9 mmHg but there was no statistical significance (p = 0.1392). The global T/P ratio in the fimasartan 30 mg groups were 0.48 and 0.40 in the valsartan 80 mg group, respectively (p = 0.3411). The most frequent adverse events (AEs) were acute pharyngitis and there were no cases of severe AEs.
CONCLUSIONS
In mild-to-moderate hypertensive patients, low dose (30 mg) fimasartan showed comparable 24-hour BP lowering efficacy compared with valsartan (80 mg). There was no difference in tolerability between two groups.

Keyword

Hypertension; Angiotensin II type 1 receptor blockers; Blood pressure monitoring, ambulatory

MeSH Terms

Angiotensin II Type 1 Receptor Blockers
Blood Pressure Monitoring, Ambulatory
Blood Pressure*
Humans
Hypertension*
Pharyngitis
Prospective Studies
Receptor, Angiotensin, Type 1
Valsartan
Angiotensin II Type 1 Receptor Blockers
Receptor, Angiotensin, Type 1
Valsartan
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