A randomized, double-blind comparison of the antihypertensive efficacy and safety of once-daily losartan compared to twice-daily captopril in mild to moderate essential hypertension

Introduction. The antihypertensive efficacy and safety of losartan, a specific and selective angiotensin II (AII) receptor antagonist was compared to captopril in patients with mild or moderate essential hypertension. Design. This multinational, randomized trial consisted of a 4-week single-blind, placebo baseline period followed by a 12-week double-blind parallel comparison of once-daily administration of losartan 50 mg or twice-daily administration of captopril 25 mg. After 6 weeks of treatment the daily dosage was doubled in patients whose sitting diastolic blood pressure (SiDBP) remained greater than or equal to 90 mm Hg. Patients. Patients with essential hypertension having a mean trough SiDBP of 95-115 mm Hg after the placebo baseline period were randomized to losartan (N = 192) or captopril (N = 204) treatment. Main outcome measures. The primary efficacy variable was the mean change from baseline to Week 12 in trough SiDBP. Safety was assessed by recording spontaneously reported or observed adverse experiences and clinical laboratory measurements.