Publication details
Comparing recommended doses of angiotensin receptor blockers and ACE inhibitors (CORD Study)
| Authors | |
|---|---|
| Year of publication | 2009 |
| Type | Article in Periodical |
| Magazine / Source | CARDIOVASCULAR THERAPY AND PREVENTION |
| MU Faculty or unit | |
| Citation | |
| Field | Cardiovascular diseases incl. cardiosurgery |
| Keywords | Arterial hypertension; isolated systolic hypertension; ramipril; losartan; metabolic parameters; cough |
| Description | The CORD Study compared effectiveness and tolerability of losartan and ramipril in patients with arterial hypertension (AH). Material and methods. The study included two groups, A and B. In Group A (n=4016; mean age 62,6 +/- 11,6 years; 53, 1 % women), the patients with blood pressure (BP) < 160/100 mm Hg and ACE inhibitor therapy lasting for >3 months were switched from ACE inhibitors to losartan. At baseline and 1, 3, 6, and 12 months later, BP, heart rate, and biochemical parameters were measured; general blood assay and electrocardiography (ECG) were also performed. In group B (n=3813; mean age 60,5 +/- 12,2 years; 50,5% women), the patients with BP >= 140/90 mm Hg and no previous ACE inhibitor or angiotensin receptor blocker (ARB) therapy were randomly administered either losartan (50 mg/d; n=1887) or ramipril (5 mg/d; n= 1926). Results. Group A demonstrated a decrease in BP - from 147,4 +/- 14,8/87,7 +/- 9,3 to 139,7 +/- 11,8/83,0 +/- 9,3 mm Hg (p<0,001) after one month of the treatment, and to 133,7 +/- 11,3/79,1 +/- 7,06 mm Hg (p<0,001) after one year. Adverse effect prevalence did not increase. After one year, Group B demonstrated a reduction in BP levels - in losartan subgroup, from 156,5 +/- 13,1/93,4 +/- 8,8 to 134,55 +/- 11,3/80,16 +/- 6,6 mm Hg (p<0,001), and in ramipril subgrOLIP-from 155,9 +/- 13,1/93,0 +/- 8,9 to 134,1 +/- 11,2/81,5 +/- 6,8 mm Hg (p<0,001). No severe adverse effects were registered, but in ramipril subgroup, cough was 8 times more prevalent. Conclusion. ACE inhibitor substitution with losartan was safe and effective. Losartan and ramipril demonstrated equal anti hypertensive effectiveness and a tendency to improve metabolic parameters. Losartan therapy was better tolerated than ramipril. |