Antihypertensive effects and safety of eprosartan: a meta-analysis of randomized controlled trials

• Published in: European journal of clinical pharmacology 2012-02, Vol.68 (2), p.195-205
• Main Authors: Xu, Feng-Ying, Yang, Bo, Shi, Duo, Li, Hao, Zou, Zui, Shi, Xue-Yin
• Format: Article
• Language: English
• Subjects: Acrylates - adverse effects; Acrylates - therapeutic use; Adult; Aged; Angiotensin II Type 1 Receptor Blockers - adverse effects; Angiotensin II Type 1 Receptor Blockers - therapeutic use; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical trials; Drug therapy; Female; Humans; Hypertension - drug therapy; Imidazoles - adverse effects; Imidazoles - therapeutic use; Male; Medical sciences; Meta-analysis; Middle Aged; Pharmacoepidemiology and Prescription; Pharmacology. Drug treatments; Pharmacology/Toxicology; Randomized Controlled Trials as Topic; Safety; Thiophenes - adverse effects; Thiophenes - therapeutic use
• ISSN: 0031-6970; 1432-1041
• DOI: 10.1007/s00228-011-1107-3

Purpose The benefits of reducing blood pressure (BP) have been well established, but uncertainty remains about the comparative effects of different BP-lowering regimens. We aimed to estimate the efficacy and the tolerability of eprosartan compared with other agents as monotherapy. Methods PubMed, EMBASE, and Cochrane Library were searched for relevant studies. A meta-analysis of randomized controlled trials (RCTs) meeting the criteria was performed using Review Manager and Stata/SE. Results Twenty-two articles were ultimately included out of 78 studies, involving 6,460 patients. Eprosartan had a greater systolic blood pressure (SBP) reduction than placebo [weighted mean difference (WMD): 6.55, 95% confidence interval (CI) 4.86–8.25] and losartan (WMD: 2.24, 95% CI 0.08–4.40) and a greater diastolic blood pressure (DBP) reduction than placebo (WMD 3.95, 95% CI 2.77–5.13). Therapeutic response rate of BP favored eprosartan [risk ratio (RR) 1.13, 95% CI 1.03–1.24] compared with enalapril. There were no statistical differences in SBP or DBP reductions comparing eprosartan with enalapril or telmisartan. Original RCTs included comparing eprosartan with valsartan and nitrendipine reported no differences in BP-lowering efficacy. Conclusions Eprosartan monotherapy is equivalent to many first-line antihypertensive agents and is effective for the treatment of essential hypertension, especially for isolated systolic hypertension. The favorable efficacy and tolerability make eprosartan worthwhile to be taken into consideration by physicians.