| pathology | treatment | patient | Demonstrated benefit and harm | k | | | |
|---|
| acute myocardial infarction | losartan | not classified | versus No demonstrated result for efficacy Losartan inferior to Captopril in terms of Cardiovascular death in OPTIMAAL, 2002 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| OPTIMAAL, 2002 | Losartan vs Captopril | Angioedema 0.28 [0.09; 0.86] | Cardiovascular death 1.15 [1.01; 1.31] | cancer death 1.00 [0.65; 1.52] Hypotension 0.77 [0.53; 1.12] |
| Trial | Treatments | Patients | Method |
|---|
| OPTIMAAL, 2002 | Losartan, target dose of 50 mg daily (n=2744) vs. Captopril, traget dose of 50 mg 3 times daily (n=2733) | patients within 10 days of a confirmed acute myocardial
infarction and heart failure during the acute phase or a new
Q-wave anterior infarction or reinfarction | Double blind Parallel groups Sample size: 2744/2733 Primary endpoint: all-cause mortality FU duration: 2.7 y |
|
| acute myocardial infarction | valsartan | not classified | versus No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| VALIANT (valsartan alone), 2003 | Valsartan vs Captopril | | | Cardiovascular death 1.00 [0.91; 1.09] | | VALIANT (valsartan+capropril), 2003 | Valsartan+ACE inhibitor vs ACE inhibitor only | | | Cardiovascular death 1.00 [0.92; 1.09] |
| Trial | Treatments | Patients | Method |
|---|
| VALIANT (valsartan alone), 2003 | Valsartan, 160 mg twice daily (n=4909) vs. Captopril, 50 mg 3 times daily (n=4909) | patients within 10 days of a MI complicated by HF | Double blind Parallel groups Sample size: 4909/4909 Primary endpoint: mortality from any cause FU duration: Median, 24.7 mo | | VALIANT (valsartan+capropril), 2003 | Valsartan, 40 mg twice daily, plus captopril, 25 mg three times daily (n=4885) vs. Captopril, 25 mg 3 times daily (n=4909) | patients within 10 days of a MI complicated by HF | Double blind Parallel groups Sample size: 4885/4909 Primary endpoint: mortality from any cause FU duration: Median, 24.7 mo |
|
| diabetes type 2 | irbesartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| IPDM (150mg), 2001 | irbesartan vs placebo | microvascular events 0.30 [0.14; 0.64] | | |
| Trial | Treatments | Patients | Method |
|---|
| IPDM (150mg), 2001 | irbesartan 150 mg daily (n=195) vs. placebo (n=201) 3 arms trial: irbesartan 150 and 300 mg daily, placebo | hypertensive patients with type 2 diabetes and microalbuminuria | double-blind Parallel groups Sample size: 195/201 Primary endpoint: diabetic nephropathy FU duration: 2 years |
|
| diabetes type 2 | irbesartan | not classified | versus calcium-channel blockers No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| IDNT (irbesartan vs amlodipine), 2001 | irbesartan vs amlodipine | microvascular events 0.77 [0.63; 0.94] | | All deaths 1.04 [0.77; 1.40] Cardiovascular events 1.03 [0.81; 1.31] |
| Trial | Treatments | Patients | Method |
|---|
| IDNT (irbesartan vs amlodipine), 2001 | Irbesartan 300 mg daily (n=579) vs. amlodipine 10 mg daily (n=567)
| hypertensive patients with nephropathy due to type 2 diabetes
| double blind Parallel groups Sample size: 579/567 Primary endpoint: renal death FU duration: 2.6 years
|
|
| diabetes type 2 | losartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| RENAAL, 2001 | losartan vs placebo | microvascular events 0.79 [0.66; 0.95] | | All deaths 1.02 [0.80; 1.30] |
| Trial | Treatments | Patients | Method |
|---|
| RENAAL, 2001 | losartan 50 to 100 mg once daily (n=751) vs. placebo (n=762) | patients with type 2 diabetes and nephropathy | double-blind Parallel groups Sample size: 751/762 Primary endpoint: doubling of the creatinine, end-stage renal disease, death FU duration: 3.4 y |
|
| diabetes type 2 | olmesartan | not classified | versus placebo or control No demonstrated result for efficacy olmesartan inferior to placebo in terms of CV death in ROADMAP, 2010 | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ROADMAP, 2010 | olmesartan vs placebo | onset of microalbuminuria 0.77 [0.63; 0.94] | CV death 4.96 [1.44; 17.12] | all cause death 1.72 [0.91; 3.24] non fatal stroke 1.74 [0.73; 4.13] non fatal MI 0.65 [0.35; 1.19] CV events 0.88 [0.63; 1.23] | | ORIENT | olmesartan vs placebo | | | all cause death 0.96 [0.52; 1.75] CV death 3.36 [0.93; 12.07] non fatal stroke 0.73 [0.30; 1.79] non fatal MI 0.43 [0.11; 1.65] |
| Trial | Treatments | Patients | Method |
|---|
| ROADMAP, 2010 | olmesartan at 40 mg/day (n=2232) vs. placebo (n=2215) | patients with diabetes and at least one additional cardiovascular risk factor, but no evidence of renal dysfunction | double-blind Parallel groups Sample size: 2232/2215 Primary endpoint: microalbuminuria FU duration: 3.2 y | | ORIENT | olmesartan (n=282) vs. placebo (n=284) | patients with diabetic Nephropathy and overt proteinuria secondary to type 2 diabetes mellitus | double-blind Parallel groups Sample size: 282/284 Primary endpoint: FU duration: |
|
| heart failure | candesartan | not classified | versus placebo or control No demonstrated result for efficacy candesartan inferior to placebo in terms of Hypotension in CHARM-Alternative, 2003 candesartan inferior to placebo in terms of Hyperkalaemia in CHARM-Alternative, 2003 candesartan inferior to placebo in terms of Increase in creatinine in CHARM-Alternative, 2003 | 6 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ARCH-J, 2003 | candesartan vs placebo | | | | | CHARM-Alternative, 2003 | candesartan vs placebo | Cardiovascular death or hospital admission for CHF 0.82 [0.73; 0.93] | Hypotension 4.12 [2.00; 8.49] Hyperkalaemia 6.35 [1.88; 21.38] Increase in creatinine 2.30 [1.48; 3.58] | lung cancer 3.34 [0.92; 12.10] prostate cancer 2.67 [0.71; 10.01] breast cancer 1.26 [0.34; 4.64] Cardiovascular death 0.87 [0.74; 1.02] Angioedema ∞ [NaN; ∞] | | Mitrovic et al., 2003 | candesartan vs placebo | Hypotension 0.25 [0.07; 0.97] | | Cardiovascular death 0.63 [0.13; 3.15] | | SPICE, 2000 | candesartan vs placebo | | | all cause death 1.02 [0.26; 3.97] all cause death or hospital admission 0.82 [0.43; 1.56] hospital admission for heart failure 0.69 [0.33; 1.45] Cough 1.05 [0.88; 1.26] hospital admission for any reason 0.69 [0.39; 1.22] | | STRETCH, 1999 | candesartan vs placebo | | | | | CHARM preserved, 2003 | candesartan vs placebo | | | |
| Trial | Treatments | Patients | Method |
|---|
| ARCH-J, 2003 | Candesartan, 8 mg daily (n=148) vs. Placebo (n=144) | patients with chronic heart failure who were not receiving ACE inhibitor therapy | double blind Parallel groups Sample size: 148/144 Primary endpoint: progression of CHF or addition or dose escalation of CHF medications FU duration: 155 d | | CHARM-Alternative, 2003 | candesartan (target dose32 mg once daily) (n=1013) vs. Placebo (n=1015) | patients with symptomatic heart failure and left-ventricular ejection fraction 40% or less who were notreceiving ACE inhibitors because of previous intolerance | double blind Parallel groups Sample size: 1013/1015 Primary endpoint: Cardiovascular death or hospital admission for CHF FU duration: Median, 33.7 mo | | Mitrovic et al., 2003 | Candesartan, 2 mg, 4mg, 8mg, 16mg daily (n=174) vs. Placebo (n=44) | patients with CHF (New York Heart Association
class II or III) with impaired left ventricular function (ejection fraction <=40%) and pulmonary capillary wedge pressure
>=13 mm Hg | double blind Parallel groups Sample size: 174/44 Primary endpoint: hemdodynamic FU duration: 12 wk | | SPICE, 2000 | Candesartan, 16 mg daily (n=179) vs. Placebo (n=91) | patients with chronic heart failure and left ventricular ejection fraction less than 35%, and history of discontinuing an ACE inhibitor because of intolerance | double blind Parallel groups Sample size: 179/91 Primary endpoint: tolerability FU duration: 12 wk | | STRETCH, 1999 | Candesartan, 4 mg, 8mg, 16mg daily (n=633) vs. Placebo (n=211) | Male and female patients 21 to 80 years of age with mild to moderate symptomatic CHF
(NYHA class II or III) | Double blind Parallel groups Sample size: 633/211 Primary endpoint: total exercise time FU duration: 12 wk | | CHARM preserved, 2003 | candesartan target dose 32 mg once daily (n=1514) vs. placebo (n=1509) | patients with NYHA II-IV heart failure and LVEF higher than 40% | double blind Parallel groups Sample size: 1514/1509 Primary endpoint: cardiovascular death or admission to FU duration: 36.6 months |
|
| heart failure | candesartan | not classified | versus angiotensin-converting enzyme inhibitors No demonstrated result for efficacy candesartan+ACE inhibitor inferior to ACE inhibitor only in terms of Hyperkalaemia in CHARM-Added, 2003 candesartan+ACE inhibitor inferior to ACE inhibitor only in terms of Increase in creatinine in CHARM-Added, 2003 | 3 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| CHARM-Added, 2003 | candesartan+ACE inhibitor vs ACE inhibitor only | | Hyperkalaemia 4.87 [2.39; 9.94] Increase in creatinine 1.92 [1.38; 2.66] | lung cancer 1.71 [0.67; 4.33] prostate cancer 0.77 [0.29; 2.07] Hypotension 1.45 [0.97; 2.15] Angioedema 0.66 [0.11; 3.97] | | RESOLVD (candesartan alone), 1999 | candesartan vs enalapril | | | Hypotension 1.00 [0.11; 9.51] | | RESOLVD association, 1999 | candesartan+ACE inhibitor vs ACE inhibitor only | | | Increase in creatinine ∞ [NaN; ∞] |
| Trial | Treatments | Patients | Method |
|---|
| CHARM-Added, 2003 | Candesartantarget dose 32 mg once daily (n=1276) vs. Placebo (n=1272) | patients with New York Heart Association functional class II–IV CHF and left-ventricular ejection fraction40% or lower, and who were being treated with ACE inhibitors. | double blind Parallel groups Sample size: 1276/1272 Primary endpoint: cardiovascular death or FU duration: Median, 41 mo | | RESOLVD (candesartan alone), 1999 | Candesartan, 4 mg, 8mg, 16mg daily (n=327) vs. Enalapril, 10 mg twice daily (n=109) | Patients with New York Heart Association functional class NYHA
II, III, or IV CHF, 6-minute walk distance (6MWD) >500 m, and ejection fraction (EF) <0.40 | Double blind Parallel groups Sample size: 327/109 Primary endpoint: hemodynamic FU duration: 43 wk | | RESOLVD association, 1999 | Candesartan, 4 mg, 8mg daily, plus enalapril, 10 mg twice daily (n=332) vs. Enalapril, 10 mg twice daily (n=109) | Patients with New York Heart Association functional class NYHA
II, III, or IV CHF, 6-minute walk distance (6MWD) >500 m, and ejection fraction (EF) <0.40 | Parallel groups Sample size: 332/109 Primary endpoint: hemodynamic FU duration: 43 wk |
|
| heart failure | irbesartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| I-PRESERVE (McMurray), 2008 | ibesartan vs placebo | | | Death from Any Cause, Cardiac Arrest with Resuscitation, Hospitalization for Worsening Heart Failure, or Therapy with Intravenous Inotropes or Vasodilators 0.97 [0.89; 1.05] all cause death 1.02 [0.91; 1.14] Cardiovascular death 1.03 [0.89; 1.19] hospital admission for heart failure 0.96 [0.84; 1.11] hospital admission for any reason 1.02 [0.97; 1.08] death or CV hospitalization 0.97 [0.89; 1.05] Cardiovascular death or hospital admission for CHF 0.97 [0.87; 1.10] |
| Trial | Treatments | Patients | Method |
|---|
| I-PRESERVE (McMurray), 2008 | ibersatan 300mg daily (n=2067) vs. placebo (n=2061) | patients with NYHA
II, III, or IV heart failure and an ejection fraction of at least 45% | double blind Parallel groups Sample size: 2067/2061 Primary endpoint: FU duration: 49.5 months |
|
| heart failure | irbesartan | not classified | versus angiotensin-converting enzyme inhibitors No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| Tonkon et al., 2000 | irbesartan+ACE inhibitor vs ACE inhibitor only | | | |
| Trial | Treatments | Patients | Method |
|---|
| Tonkon et al., 2000 | Irbesartan, 150 mg daily (plus ACE inhibitor) (n=57) vs. Placebo (plus ACE inhibitor) (n=52) | patients with heart failure (New York Heart Association functional class II and III) and left ventricular ejection fraction (LVEF) < or = 40% received stable doses of ACE inhibitors and diuretics | double blind Parallel groups Sample size: 57/52 Primary endpoint: Exercise tolerance FU duration: 12 wk |
|
| heart failure | losartan | not classified | versus angiotensin receptor blocker No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| HEAAL, 2009 | losartan 150mg vs losartan 50mg | all cause death or hospital admission 0.90 [0.82; 0.99] hospital admission for heart failure 0.87 [0.77; 0.99] | | all cause death 0.94 [0.84; 1.05] Adverse effect leading to treatment discontinuation 1.11 [0.88; 1.39] Hypotension 1.18 [0.61; 2.29] Angioedema ∞ [NaN; ∞] Hyperkalaemia 2.24 [0.69; 7.26] death or CV hospitalization 0.92 [0.84; 1.00] Increase in creatinine 1.33 [0.87; 2.04] |
| Trial | Treatments | Patients | Method |
|---|
| HEAAL, 2009 | losartan 150mg daily (n=1921) vs. losartan 50 mg daily (n=1913) | patients with systolic heart failure who couldn't tolerate ACE inhibitors | double blind Parallel groups Sample size: 1921/1913 Primary endpoint: death, admission for heart failure FU duration: 4.7 y (median) |
|
| heart failure | losartan | not classified | versus placebo or control No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| Losartan Phase III International, 1996 | losartan vs placebo | all cause death 0.17 [0.05; 0.62] | | | | Losartan Phase III U.S., 1995 | losartan vs placebo | | | all cause death 0.48 [0.12; 1.89] |
| Trial | Treatments | Patients | Method |
|---|
| Losartan Phase III International, 1996 | Losartan, 50 mg daily (n=254) vs. Placebo (n=131) | patients with heart failure who had never received ACE inibitors or who had discontinued ACE inhibitors | double blind Parallel groups Sample size: 254/131 Primary endpoint: Exercise FU duration: 12 wk | | Losartan Phase III U.S., 1995 | Losartan, 50 mg daily (n=237) vs. Placebo (n=114) | patients with heart failure who had never received ACE inibitors or who had discontinued ACE inhibitors | double blind Parallel groups Sample size: 237/114 Primary endpoint: Exercise FU duration: 12 wk |
|
| heart failure | losartan | not classified | versus angiotensin-converting enzyme inhibitors No demonstrated result for efficacy | 7 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| Dickstein et al., 1995 | losartan vs enalapril | | | | | ELITE, 1997 | losartan vs captopril | | | Cardiovascular death 0.53 [0.27; 1.03] Hypotension 1.68 [0.56; 5.09] Angioedema 0.00 [0.00; NaN] Hyperkalaemia 0.35 [0.07; 1.72] Increase in creatinine 1.00 [0.65; 1.53] | | ELITE II, 2000 | losartan vs captopril | | | | | Hamroff et al., 1999 | losartan+ACE inhibitor vs ACE inhibitor only | | | | | Lang et al., 1997 | losartan vs enalapril | | | | | Losartan phase II S, 1996 | losartan vs enalapril | | | | | losartan phase II US, 1996 | losartan vs enalapril | | | |
| Trial | Treatments | Patients | Method |
|---|
| Dickstein et al., 1995 | Losartan, 25 mg, 50mg daily (n=108) vs. Enalapril, 10 mg twice daily (n=58) | patients with moderate or severe chronic heart failure in New York Heart Association functional class III or IV and an ejection fraction < or = 35% | double blind Parallel groups Sample size: 108/58 Primary endpoint: clinical status and exercise performance FU duration: 8 wk | | ELITE, 1997 | Losartan titrated to 50 mg once daily (n=352) vs. Captopril,titratedto 50 mg three times daily (n=370) | ACE inhibitor naive patients (aged 65 years or more) with New York HeartAssociation (NYHA) class II–IV heart failure and ejection fractions of 40% or less | Double blind Parallel groups Sample size: 352/370 Primary endpoint: tolerability measure of a persist ing FU duration: 48 wk | | ELITE II, 2000 | Losartan, target dose 50 mg daily (n=1578) vs. Captopril, target dose 50 mg 3 times daily (n=1574) | patients aged 60 years or older with New York Heart Association class II–IV heart failure and ejection fraction of 40% or less. | Double blind Parallel groups Sample size: 1578/1574 Primary endpoint: All-cause mortalityur=na FU duration: median 1.5y | | Hamroff et al., 1999 | Losartan, 50 mg daily (plus ACE inhibitor) (n=16) vs. Placebo (plus ACE inhibitor) (n=17) | patients with severe congestive heart failure (NYHA III-IV) despite treatment with maximally recommended or tolerated doses of ACE inhibitors | double blind Parallel groups Sample size: 16/17 Primary endpoint: exercise capacity FU duration: 6 mo | | Lang et al., 1997 | Losartan titrated to 25 mg ou 50 mg daily (n=78) vs. Enalapril, titrated to 10 mg twice daily (n=38) Three arms: losartan 25mg/d, losaratan 50mg/d and enalapril 20mg/d. The 2 losartan group has been pooled | patients with congestive heart failure (New York Heart Association functionalclasses II to IV) and left ventricular ejection fraction <= 45%previously treated with stable doses of ACE inhibitors and diureticagents, with or without concurrent digitalis and othervasodilators | Double blind Parallel groups Sample size: 78/38 Primary endpoint: maximal treadmill FU duration: 12 wk | | Losartan phase II S, 1996 | losartan 50 or 25 mg/d (n=108) vs. enalapril 10mg twice daily (n=58) | patient with heart failure | double blind Parallel groups Sample size: 108/58 Primary endpoint: exercise FU duration: 8 weeks | | losartan phase II US, 1996 | losartan 25 and 50 mg/d (n=78) vs. enalapril 10mg twice daily (n=38) | patients with heart failure | double blind Parallel groups Sample size: 78/38 Primary endpoint: exercise FU duration: 12 weeks |
|
| heart failure | telmisartan | not classified | versus angiotensin-converting enzyme inhibitors No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| REPLACE, 2001 | telmisartan vs enalapril | | | |
| Trial | Treatments | Patients | Method |
|---|
| REPLACE, 2001 | Telmisartan, 10 mg, 20mg, 40mg, 80mg daily (n=301) vs. Enalapril, 10 mg twice daily (n=77) | ambulatory patients at least 21 years of age, in sinus rhythm, with chronic moderatesymptomatic heart failure (New York Heart Associatality.tion class II–III) and a left ventricular ejection fraction of 40% or lower | Double blind Parallel groups Sample size: 301/77 Primary endpoint: exercise test durationge FU duration: 12 wk |
|
| heart failure | valsartan | not classified | versus placebo or control No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| Mazayev et al. (vs placebo), 1998 | valsartan vs placebo | | | | | VALIDD, 2007 | valsartan vs no valsartan | | | cancer 5.32 [0.63; 45.15] |
| Trial | Treatments | Patients | Method |
|---|
| Mazayev et al. (vs placebo), 1998 | valsartan 40, 80 or 160 mg twice daily (n=75) vs. Placebo (n=26) | patients with chronic heart failure previously untreated with ACE inhibitors | Double blind Parallel groups Sample size: 75/26 Primary endpoint: pulmonary capillary wedge pressure FU duration: 4 wk | | VALIDD, 2007 | valsartan titrated up to 320 mg once daily (n=186) vs. placebo (n=198) | Patients with hypertension and evidence of diastolic dysfunction | double blind Parallel groups Sample size: 186/198 Primary endpoint: diastolic relaxation velocity FU duration: 38 weeks |
|
| heart failure | valsartan | not classified | versus angiotensin-converting enzyme inhibitors No demonstrated result for efficacy valsartan+ACE inhibitor inferior to ACE inhibitor only in terms of Adverse effect leading to treatment discontinuation in Val-HeFT, 2001 valsartan+ACE inhibitor inferior to ACE inhibitor only in terms of Increase in creatinine in Val-HeFT, 2001 | 4 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| HEAVEN, 2002 | valsartan vs enalapril | | | | | V-HeFT, 1999 | valsartan+ACE inhibitor vs ACE inhibitor only | | | Hypotension ∞ [NaN; ∞] Hyperkalaemia ∞ [NaN; ∞] Increase in creatinine 1.02 [0.10; 10.75] | | Val-HeFT, 2001 | valsartan+ACE inhibitor vs ACE inhibitor only | Death from Any Cause, Cardiac Arrest with Resuscitation, Hospitalization for Worsening Heart Failure, or Therapy with Intravenous Inotropes or Vasodilators 0.90 [0.83; 0.98] hospital admission for heart failure 0.76 [0.67; 0.86] | Adverse effect leading to treatment discontinuation 1.46 [1.20; 1.77] Increase in creatinine 6.73 [2.36; 19.19] | cancer death 1.00 [0.60; 1.65] all cause death 1.02 [0.91; 1.14] Hypotension 1.68 [0.95; 2.95] | | Mazayev et al. (vs lisinopril, 1998 | valsartan vs Lisinopril | | | |
| Trial | Treatments | Patients | Method |
|---|
| HEAVEN, 2002 | Valsartan, 160 mg daily (n=70) vs. Enalapril, 10 mg twice daily (n=71) | Men and women with mild/moderate heart failure stabilised on an angiotensin-converting enzyme inhibitor and left ventricular ejection fraction 0.45 or less | Double blind Parallel groups Sample size: 70/71 Primary endpoint: exercise capacity, FU duration: 12 wk | | V-HeFT, 1999 | Valsartan 80 mg and 160mg twice daily (plus ACE inhibitor) (n=55) vs. Placebo (plus usual ACE inhibitor) (n=28) | Patients with stable symptomatic congestive heart failure (CHF) receiving long-term ACE inhibitor therapy (NYHA functional class II,III, or IV) and PCWP >or=to 15 mm Hg | Double blind Parallel groups Sample size: 55/28 Primary endpoint: change from baseline in PCWP FU duration: 4 wk | | Val-HeFT, 2001 | Valsartan, 160 mg twice daily (plus ACE inhibitor) (n=2511) vs. Placebo (plus ACE inhibitor) (n=2499) | patients with heart failure of New York Heart Association (NYHA) class II, III, or IV | Double blind Parallel groups Sample size: 2511/2499 Primary endpoint: moratlity and morbidity FU duration: 23 mo | | Mazayev et al. (vs lisinopril, 1998 | Valsartan, 40 mg, 80mg, 160mg twice daily (n=75) vs. lisinopril 10mg once daily (n=15) | patients with chronic heart failure | NA Parallel groups Sample size: 75/15 Primary endpoint: pulmonary capillary wedge pressure FU duration: 4 wk |
|
| hypertension | candesartan | not classified | versus placebo or control No demonstrated result for efficacy | 6 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| SCOPE, 2003 | candesartan vs placebo | | | cardiovascular death 0.95 [0.76; 1.18] all cause death 0.97 [0.82; 1.14] coronary event 1.10 [0.79; 1.54] Cardiovascular death 0.95 [0.76; 1.18] cancer 1.08 [0.89; 1.31] stroke (fatal and non fatal) 0.77 [0.59; 1.01] Myocardial infarction ( fatal and non fatal) 1.10 [0.79; 1.54] cardiac death 0.99 [0.52; 1.90] cardiovascular event 0.90 [0.76; 1.06] New onset diabetes 0.80 [0.63; 1.03] | | HIJ-CREATE, 2009 | Candesartan vs usual care | | | | | E-COST, 2005 | candesartan vs conventional treatment | stroke (fatal and non fatal) 0.58 [0.41; 0.82] Myocardial infarction ( fatal and non fatal) 0.41 [0.20; 0.86] | | all cause death 0.94 [0.24; 3.77] Cardiovascular death ∞ [NaN; ∞] Heart failure 0.81 [0.52; 1.26] | | E-COST-R, 2005 | candesartan vs conventional treatment | | | all cause death 1.04 [0.27; 4.01] Cardiovascular death 1.04 [0.27; 4.01] Heart failure 0.68 [0.34; 1.34] stroke (fatal and non fatal) 0.89 [0.51; 1.55] Myocardial infarction ( fatal and non fatal) 2.09 [0.39; 11.03] | | HIJ-CREATE, 2009 | candesartan vs conventional treatment | New onset diabetes 0.39 [0.16; 0.93] | | all cause death 1.17 [0.84; 1.64] Cardiovascular death 1.12 [0.66; 1.91] Heart failure 0.91 [0.60; 1.38] stroke (fatal and non fatal) 0.92 [0.62; 1.36] Myocardial infarction ( fatal and non fatal) 1.12 [0.66; 1.88] | | Takahashi, 2006 | candesartan vs control | | | all cause death 0.00 [0.00; NaN] Heart failure 0.39 [0.15; 1.02] |
| Trial | Treatments | Patients | Method |
|---|
| SCOPE, 2003 | candesartan, 8–16 mg once daily (target 160/90) (n=2477) vs. placebo (n=2460) | patients aged 70–89 years, with systolic blood pressure 160– 179 mmHg, and/or diastolic blood pressure 90–99 mmHg, and a Mini Mental State Examination (MMSE) test score > 24 | double-blind Parallel groups Sample size: 2477/2460 Primary endpoint: major cardiovascular events FU duration: 3.7 y (mean) | | HIJ-CREATE, 2009 | cardesartan adjusted dose for target arterial pressure of <130/85 mmHg (n=1025) vs. usual care (non-ARB-based pharmacotherapy including angiotensin-converting enzyme-inhibitors) (n=1024) | hypertension with angiographically documented coronary artery disease (acute or stable) | open Parallel groups Sample size: 1025/1024 Primary endpoint: MACE FU duration: up to 60 months | | E-COST, 2005 | candesartan, 2 to 12 mg daily (n=1053) vs. conventional antihypertensive drugs other than angiotensin converting enzyme inhibitors or ARBs (n=995) | Japanese essential hypertensive subjects (sitting blood pressure 140-180/90-110 mmHg) aged 35-79 years | single-blind Parallel groups Sample size: 1053/995 Primary endpoint: CV hospitalization FU duration: | | E-COST-R, 2005 | candesartan (n=69) vs. conventional treatment (n=72) | hypertensive subjects 60 to 75 years old with non-diabetic chronic renal insufficiency | open Parallel groups Sample size: 69/72 Primary endpoint: cardiovascular event FU duration: | | HIJ-CREATE, 2009 | angiotensin II receptor blocker-based therapy (n=1024) vs. non-angiotensin II receptor blocker-based therapy (n=1025) | patients with angiographically documented coronary artery disease and hypertension | open Parallel groups Sample size: 1024/1025 Primary endpoint: CV events FU duration: 4.2 y (median) | | Takahashi, 2006 | candesartan (n=43) vs. control (n=37) | patients on chronic haemodialysis in stable condition and with no clinical evidence of cardiac disorders | open Parallel groups Sample size: 43/37 Primary endpoint: cardiovascular events FU duration: 19.4 months |
|
| hypertension | candesartan | not classified | versus calcium-channel blockers No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| CASE-J, 2008 | candesartan vs amlodipine | New onset diabetes 0.64 [0.42; 0.96] | | all cause death 0.85 [0.62; 1.15] Heart failure 1.25 [0.65; 2.40] stroke (fatal and non fatal) 1.27 [0.87; 1.86] Myocardial infarction ( fatal and non fatal) 0.94 [0.49; 1.82] |
| Trial | Treatments | Patients | Method |
|---|
| CASE-J, 2008 | candesartan-based regimen (n=2354) vs. amlodipine-based regimen (n=2349) | high-risk Japanese hypertensive patients | open (blinded assessment) Parallel groups Sample size: 2354/2349 Primary endpoint: FU duration: 3.2 years |
|
| hypertension | candesartan | not classified | versus diuretics No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ALPINE, 2003 | candesartan vs hydrochlorothiazide | New onset diabetes 0.12 [0.02; 0.99] | | cardiovascular death NaN [NaN; NaN] all cause death NaN [NaN; NaN] coronary event 0.99 [0.06; 15.80] Cardiovascular death NaN [NaN; NaN] stroke (fatal and non fatal) NaN [NaN; NaN] Myocardial infarction ( fatal and non fatal) 0.99 [0.06; 15.80] cardiovascular event 0.99 [0.06; 15.80] |
| Trial | Treatments | Patients | Method |
|---|
| ALPINE, 2003 | candesartan (n=197) vs. hydrochlorothiazide (n=196) | newly detected hypertensives | double-blind Parallel groups Sample size: 197/196 Primary endpoint: diabetes FU duration: 1 year |
|
| hypertension | captopril | not classified | versus ACEIs No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| VALIANT/Val+Cap, 2003 | Valsartan + captopril vs Captopril | | | all-cause mortality 0.99 [0.91; 1.07] cardiovascular mortality 1.00 [0.92; 1.09] stroke 0.87 [0.72; 1.06] MI 0.95 [0.87; 1.04] |
| Trial | Treatments | Patients | Method |
|---|
| VALIANT/Val+Cap, 2003 | Valsartan + captopril (n=4885) vs. Captopril (n=4909) | patients with myocardial infarction complicated by left ventricular systolic dysfunction, heart failure, or both | double-blind Parallel groups Sample size: 4885/4909 Primary endpoint: death from any cause FU duration: 2.1 y |
|
| hypertension | irbesartan | not classified | versus placebo or control No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| IDNT (irbesartan vs pbo), 2001 | irbesartan vs placebo | | | all cause death 0.92 [0.70; 1.20] coronary event 0.91 [0.72; 1.15] Cardiovascular death 1.11 [0.76; 1.62] Heart failure 0.82 [0.59; 1.13] stroke (fatal and non fatal) 1.06 [0.63; 1.78] Myocardial infarction ( fatal and non fatal) 0.94 [0.63; 1.40] | | IRMA 2, 2001 | irbesartan vs placebo | | | all cause death 1.13 [0.40; 3.20] Myocardial infarction ( fatal and non fatal) 0.51 [0.15; 1.75] |
| Trial | Treatments | Patients | Method |
|---|
| IDNT (irbesartan vs pbo), 2001 | Irbesartan 300mg/d (target 135/85) (n=579) vs. placebo (n=569) | hypertensive patients with nephropathy due to type 2 diabetes | double-blind Parallel groups Sample size: 579/569 Primary endpoint: doubling of the base-line serum creatinine concentration, end-stage renal disease, or death FU duration: 2.6 y | | IRMA 2, 2001 | irbesartan 150 mg daily or 300 mg daily (n=404) vs. placebo (n=207) | hypertensive patients with type 2 diabetes and microalbuminuria | double-blind Parallel groups Sample size: 404/207 Primary endpoint: onset of diabetic nephropathy FU duration: 2 years |
|
| hypertension | losartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| RENAAL, 2001 | losartan vs placebo | | | |
| Trial | Treatments | Patients | Method |
|---|
| RENAAL, 2001 | lLosartan 50 to 100 mg once daily (n=751) vs. placebo (n=762) | patients with type 2 diabetes and nephropathy | double-blind Parallel groups Sample size: 751/762 Primary endpoint: doubling of the base-line serum creatinine concentration, end-stage renal disease, or death FU duration: 3.4 years |
|
| hypertension | losartan | not classified | versus ACEIs No demonstrated result for efficacy Losartan inferior to Captopril in terms of cardiovascular mortality in OPTIMAAL, 2001 | 3 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ELITE, 1997 | Losartan vs Captopril | all-cause mortality 0.56 [0.32; 0.99] | | cardiovascular mortality 0.53 [0.27; 1.03] stroke 1.40 [0.32; 6.22] MI 0.79 [0.18; 3.50] | | ELITE-II, 2000 | Losartan vs Captopril | | | all-cause mortality 1.12 [0.96; 1.31] cardiovascular mortality 1.15 [0.97; 1.38] stroke 1.63 [0.77; 3.44] MI 1.10 [0.67; 1.83] | | OPTIMAAL, 2001 | Losartan vs Captopril | | cardiovascular mortality 1.15 [1.01; 1.31] | all-cause mortality 1.11 [0.99; 1.25] stroke 1.06 [0.84; 1.33] MI 1.01 [0.88; 1.15] |
| Trial | Treatments | Patients | Method |
|---|
| ELITE, 1997 | Losartan titrated to 50 mg once daily for 48 weeks (n=352) vs. Captopril titrated to 50 mg three times daily for 48 weeks (n=370) | naive patients (aged 65 years or more) with NYHA class II-IV heart failure and ejection fractions of 40% or less | double-blind Parallel groups Sample size: 352/370 Primary endpoint: persisting increase in serum creatinine of 26.5 mumol/L or more FU duration: 1 y | | ELITE-II, 2000 | Losartan titrated to 50 mg once daily (n=1578) vs. Captopril titrated to 50 mg three times daily (n=1574) | patients aged 60 years or older with New York Heart Association class II-IV heart failure and ejection fraction of 40% or less. Patients | double-blind Parallel groups Sample size: 1578/1574 Primary endpoint: all cause death FU duration: 1.5 y | | OPTIMAAL, 2001 | losartan (titrated to 50 mg once daily) (n=2744) vs. Captopril (titrated to 50 mg three times daily) (n=2733) | patients 50 years of age or older, with confirmed acute myocardial infarction and heart failure during the acute phase or a new Q-wave anterior infarction or reinfarction | NA Parallel groups Sample size: 2744/2733 Primary endpoint: all cause death FU duration: 2.7 y |
|
| hypertension | losartan | not classified | versus beta-blockers No demonstrated result for efficacy losartan inferior to atenolol in terms of PAD inférieure à 90 in LIFE, 2002 losartan inferior to atenolol in terms of lung cancer in LIFE, 2002 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| LIFE, 2002 | losartan vs atenolol | apparition d'un premier évènement cardiovasculaire 0.86 [0.77; 0.96] PAS inférieure à 140 1.08 [1.03; 1.12] PA inférieure à140/90 1.07 [1.02; 1.11] stroke (fatal and non fatal) 0.75 [0.63; 0.88] cardiovascular event 0.86 [0.77; 0.96] New onset diabetes 0.75 [0.64; 0.89] | PAD inférieure à 90 0.98 [0.97; 1.00] lung cancer 2.41 [1.23; 4.71] | cardiovascular death 0.87 [0.72; 1.04] cancer occurence(prespecified endpoint) 1.11 [0.96; 1.29] cancer occurence 1.11 [0.96; 1.29] all cause death 0.89 [0.78; 1.01] coronary event 1.05 [0.86; 1.28] Cardiovascular death 0.87 [0.72; 1.04] Heart failure 0.95 [0.76; 1.18] cancer 1.11 [0.96; 1.29] Myocardial infarction ( fatal and non fatal) 1.05 [0.86; 1.28] cancer death 1.03 [0.80; 1.34] |
| Trial | Treatments | Patients | Method |
|---|
| LIFE, 2002 | losartan (n=4605) vs. atenolol (n=4588) | patients aged 55–80 years, with previously treated or untreated hypertension (sitting blood pressure 160–200/95–115 mm Hg) and ECG signs of LVH. | Double blind Parallel groups Sample size: 4605/4588 Primary endpoint: Cardiovascular mortality, stroke, and myocardial infarction FU duration: 4.8 y (mean) |
|
| hypertension | ramipril | not classified | versus ACEIs No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ONTARGET/Tel+Ram, 2008 | Telmisartan + ramipril vs Ramipril | | | all-cause mortality 1.06 [0.98; 1.15] cardiovascular mortality 1.04 [0.93; 1.16] stroke 0.93 [0.81; 1.07] MI 1.07 [0.94; 1.22] |
| Trial | Treatments | Patients | Method |
|---|
| ONTARGET/Tel+Ram, 2008 | Telmisartan + ramipril (n=8502) vs. Ramipril (n=8576) | patients with vascular disease or high-risk diabetes | double-blind Parallel groups Sample size: 8502/8576 Primary endpoint: Cv events or hospitalization FU duration: 4.7 y |
|
| hypertension | telmisartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| PROPHESS, 2008 | telmisartan vs placebo | | | cardiovascular death 0.85 [0.71; 1.02] cancer occurence 0.96 [0.83; 1.12] all cause death 1.02 [0.93; 1.13] Cardiovascular death 0.85 [0.71; 1.02] cancer 0.96 [0.83; 1.12] stroke (fatal and non fatal) 0.95 [0.87; 1.03] Myocardial infarction ( fatal and non fatal) 1.00 [0.81; 1.23] cardiovascular event 0.94 [0.88; 1.01] New onset diabetes 0.83 [0.66; 1.05] lung cancer 1.24 [0.77; 2.00] |
| Trial | Treatments | Patients | Method |
|---|
| PROPHESS, 2008 | telmisartan 80 mg daily (n=10146) vs. placebo (n=10186) | patients who recently had an ischemic stroke | double blind Factorial plan Sample size: 10146/10186 Primary endpoint: recurrent stroke FU duration: 2.5 y |
|
| hypertension | telmisartan | not classified | versus ACEIs No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ONTARGET/Tel, 2008 | Telmisartan vs Ramipril | | | all-cause mortality 0.98 [0.90; 1.06] cardiovascular mortality 1.00 [0.89; 1.11] stroke 0.91 [0.80; 1.05] MI 1.07 [0.94; 1.22] | | DETAIL, 2004 | Telmisartan vs Enalapril | | | all-cause mortality 1.08 [0.36; 3.27] cardiovascular mortality 1.63 [0.28; 9.56] stroke 1.08 [0.36; 3.27] MI 1.63 [0.60; 4.43] |
| Trial | Treatments | Patients | Method |
|---|
| ONTARGET/Tel, 2008 | Telmisartan 80 mg daily (n=8542) vs. Ramipril 10 mg daily (n=8576) | patients with vascular disease or high-risk diabetes | double-blind Parallel groups Sample size: 8542/8576 Primary endpoint: Cv events or hospitalization FU duration: 4.7 y | | DETAIL, 2004 | Telmisartan 80 mg daily (n=120) vs. Enalapril 20 mg daily (n=130) | pateintspatients with type 2 diabetes and early nephropathy | double-blind Parallel groups Sample size: 120/130 Primary endpoint: glomerular filtration rate FU duration: 5 y |
|
| hypertension | valsartan | not classified | versus ACEIs No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| VALIANT/Val, 2003 | Valsartan vs Captopril | | | all-cause mortality 1.02 [0.94; 1.11] cardiovascular mortality 1.00 [0.91; 1.09] stroke 0.85 [0.70; 1.04] MI 1.00 [0.91; 1.09] |
| Trial | Treatments | Patients | Method |
|---|
| VALIANT/Val, 2003 | Valsartan (n=4909) vs. Captopril (n=4909) | patients with myocardial infarction complicated by left ventricular systolic dysfunction, heart failure, or both | double-blind Parallel groups Sample size: 4909/4909 Primary endpoint: death FU duration: 2.1 y |
|
| miscellaneous | candesartan | not classified | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| TROPHY, 2006 | candesartan vs placebo | hypertension 0.84 [0.75; 0.95] | | cancer 1.32 [0.30; 5.84] death cancer ∞ [NaN; ∞] lung cancer 1.00 [0.14; 7.08] Serious adverse events 0.60 [0.31; 1.15] cardiovascular events 0.16 [0.02; 1.36] |
| Trial | Treatments | Patients | Method |
|---|
| TROPHY, 2006 | candesartan during 2y followed by 2y
of placebo (n=409) vs. placebo (n=400) | subjects with repeated measurements of systolic pressure of 130 to 139 mm Hg
and diastolic pressure of 89 mm Hg or lower, or systolic pressure of 139 mm Hg or
lower and diastolic pressure of 85 to 89 mm Hg | double-blind Parallel groups Sample size: 409/400 Primary endpoint: new-onset hypertension FU duration: 4y |
|
| miscellaneous | candesartan | not classified | versus placebo or control No demonstrated result for efficacy | 5 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| SCOPE, 2003 | candesartan vs placebo | | | cardiovascular death 0.95 [0.76; 1.18] all cause death 0.97 [0.82; 1.14] coronary event 1.10 [0.79; 1.54] Cardiovascular death 0.95 [0.76; 1.18] cancer 1.08 [0.89; 1.31] stroke (fatal and non fatal) 0.77 [0.59; 1.01] Myocardial infarction ( fatal and non fatal) 1.10 [0.79; 1.54] cardiac death 0.99 [0.52; 1.90] cardiovascular event 0.90 [0.76; 1.06] New onset diabetes 0.80 [0.63; 1.03] | | E-COST, 2005 | candesartan vs conventional treatment | stroke (fatal and non fatal) 0.58 [0.41; 0.82] Myocardial infarction ( fatal and non fatal) 0.41 [0.20; 0.86] | | all cause death 0.94 [0.24; 3.77] Cardiovascular death ∞ [NaN; ∞] Heart failure 0.81 [0.52; 1.26] | | E-COST-R, 2005 | candesartan vs conventional treatment | | | all cause death 1.04 [0.27; 4.01] Cardiovascular death 1.04 [0.27; 4.01] Heart failure 0.68 [0.34; 1.34] stroke (fatal and non fatal) 0.89 [0.51; 1.55] Myocardial infarction ( fatal and non fatal) 2.09 [0.39; 11.03] | | HIJ-CREATE, 2009 | candesartan vs conventional treatment | New onset diabetes 0.39 [0.16; 0.93] | | all cause death 1.17 [0.84; 1.64] Cardiovascular death 1.12 [0.66; 1.91] Heart failure 0.91 [0.60; 1.38] stroke (fatal and non fatal) 0.92 [0.62; 1.36] Myocardial infarction ( fatal and non fatal) 1.12 [0.66; 1.88] | | Takahashi, 2006 | candesartan vs control | | | all cause death 0.00 [0.00; NaN] Heart failure 0.39 [0.15; 1.02] |
| Trial | Treatments | Patients | Method |
|---|
| SCOPE, 2003 | candesartan, 8–16 mg once daily (target 160/90) (n=2477) vs. placebo (n=2460) | patients aged 70–89 years, with systolic blood pressure 160– 179 mmHg, and/or diastolic blood pressure 90–99 mmHg, and a Mini Mental State Examination (MMSE) test score > 24 | double-blind Parallel groups Sample size: 2477/2460 Primary endpoint: major cardiovascular events FU duration: 3.7 y (mean) | | E-COST, 2005 | candesartan, 2 to 12 mg daily (n=1053) vs. conventional antihypertensive drugs other than angiotensin converting enzyme inhibitors or ARBs (n=995) | Japanese essential hypertensive subjects (sitting blood pressure 140-180/90-110 mmHg) aged 35-79 years | single-blind Parallel groups Sample size: 1053/995 Primary endpoint: CV hospitalization FU duration: | | E-COST-R, 2005 | candesartan (n=69) vs. conventional treatment (n=72) | hypertensive subjects 60 to 75 years old with non-diabetic chronic renal insufficiency | open Parallel groups Sample size: 69/72 Primary endpoint: cardiovascular event FU duration: | | HIJ-CREATE, 2009 | angiotensin II receptor blocker-based therapy (n=1024) vs. non-angiotensin II receptor blocker-based therapy (n=1025) | patients with angiographically documented coronary artery disease and hypertension | open Parallel groups Sample size: 1024/1025 Primary endpoint: CV events FU duration: 4.2 y (median) | | Takahashi, 2006 | candesartan (n=43) vs. control (n=37) | patients on chronic haemodialysis in stable condition and with no clinical evidence of cardiac disorders | open Parallel groups Sample size: 43/37 Primary endpoint: cardiovascular events FU duration: 19.4 months |
|
| miscellaneous | candesartan | not classified | versus calcium-channel blockers No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| CASE-J, 2008 | candesartan vs amlodipine | New onset diabetes 0.64 [0.42; 0.96] | | all cause death 0.85 [0.62; 1.15] Heart failure 1.25 [0.65; 2.40] stroke (fatal and non fatal) 1.27 [0.87; 1.86] Myocardial infarction ( fatal and non fatal) 0.94 [0.49; 1.82] |
| Trial | Treatments | Patients | Method |
|---|
| CASE-J, 2008 | candesartan-based regimen (n=2354) vs. amlodipine-based regimen (n=2349) | high-risk Japanese hypertensive patients | open (blinded assessment) Parallel groups Sample size: 2354/2349 Primary endpoint: FU duration: 3.2 years |
|
| miscellaneous | candesartan | not classified | versus diuretics No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ALPINE, 2003 | candesartan vs hydrochlorothiazide | New onset diabetes 0.12 [0.02; 0.99] | | cardiovascular death NaN [NaN; NaN] all cause death NaN [NaN; NaN] coronary event 0.99 [0.06; 15.80] Cardiovascular death NaN [NaN; NaN] stroke (fatal and non fatal) NaN [NaN; NaN] Myocardial infarction ( fatal and non fatal) 0.99 [0.06; 15.80] cardiovascular event 0.99 [0.06; 15.80] |
| Trial | Treatments | Patients | Method |
|---|
| ALPINE, 2003 | candesartan (n=197) vs. hydrochlorothiazide (n=196) | newly detected hypertensives | double-blind Parallel groups Sample size: 197/196 Primary endpoint: diabetes FU duration: 1 year |
|
| miscellaneous | irbesartan | not classified | versus placebo or control No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| IDNT (irbesartan vs pbo), 2001 | irbesartan vs placebo | | | all cause death 0.92 [0.70; 1.20] coronary event 0.91 [0.72; 1.15] Cardiovascular death 1.11 [0.76; 1.62] Heart failure 0.82 [0.59; 1.13] stroke (fatal and non fatal) 1.06 [0.63; 1.78] Myocardial infarction ( fatal and non fatal) 0.94 [0.63; 1.40] | | IRMA 2, 2001 | irbesartan vs placebo | | | all cause death 1.13 [0.40; 3.20] Myocardial infarction ( fatal and non fatal) 0.51 [0.15; 1.75] |
| Trial | Treatments | Patients | Method |
|---|
| IDNT (irbesartan vs pbo), 2001 | Irbesartan 300mg/d (target 135/85) (n=579) vs. placebo (n=569) | hypertensive patients with nephropathy due to type 2 diabetes | double-blind Parallel groups Sample size: 579/569 Primary endpoint: doubling of the base-line serum creatinine concentration, end-stage renal disease, or death FU duration: 2.6 y | | IRMA 2, 2001 | irbesartan 150 mg daily or 300 mg daily (n=404) vs. placebo (n=207) | hypertensive patients with type 2 diabetes and microalbuminuria | double-blind Parallel groups Sample size: 404/207 Primary endpoint: onset of diabetic nephropathy FU duration: 2 years |
|
| miscellaneous | losartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| RENAAL, 2001 | losartan vs placebo | | | |
| Trial | Treatments | Patients | Method |
|---|
| RENAAL, 2001 | lLosartan 50 to 100 mg once daily (n=751) vs. placebo (n=762) | patients with type 2 diabetes and nephropathy | double-blind Parallel groups Sample size: 751/762 Primary endpoint: doubling of the base-line serum creatinine concentration, end-stage renal disease, or death FU duration: 3.4 years |
|
| miscellaneous | losartan | not classified | versus beta-blockers No demonstrated result for efficacy losartan inferior to atenolol in terms of PAD inférieure à 90 in LIFE, 2002 losartan inferior to atenolol in terms of lung cancer in LIFE, 2002 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| LIFE, 2002 | losartan vs atenolol | apparition d'un premier évènement cardiovasculaire 0.86 [0.77; 0.96] PAS inférieure à 140 1.08 [1.03; 1.12] PA inférieure à140/90 1.07 [1.02; 1.11] stroke (fatal and non fatal) 0.75 [0.63; 0.88] cardiovascular event 0.86 [0.77; 0.96] New onset diabetes 0.75 [0.64; 0.89] | PAD inférieure à 90 0.98 [0.97; 1.00] lung cancer 2.41 [1.23; 4.71] | cardiovascular death 0.87 [0.72; 1.04] cancer occurence(prespecified endpoint) 1.11 [0.96; 1.29] cancer occurence 1.11 [0.96; 1.29] all cause death 0.89 [0.78; 1.01] coronary event 1.05 [0.86; 1.28] Cardiovascular death 0.87 [0.72; 1.04] Heart failure 0.95 [0.76; 1.18] cancer 1.11 [0.96; 1.29] Myocardial infarction ( fatal and non fatal) 1.05 [0.86; 1.28] cancer death 1.03 [0.80; 1.34] |
| Trial | Treatments | Patients | Method |
|---|
| LIFE, 2002 | losartan (n=4605) vs. atenolol (n=4588) | patients aged 55–80 years, with previously treated or untreated hypertension (sitting blood pressure 160–200/95–115 mm Hg) and ECG signs of LVH. | Double blind Parallel groups Sample size: 4605/4588 Primary endpoint: Cardiovascular mortality, stroke, and myocardial infarction FU duration: 4.8 y (mean) |
|
| miscellaneous | olmesartan | not classified | versus placebo or control No demonstrated result for efficacy olmesartan inferior to placebo in terms of CV death in ROADMAP, 2010 | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ROADMAP, 2010 | olmesartan vs placebo | onset of microalbuminuria 0.77 [0.63; 0.94] | CV death 4.96 [1.44; 17.12] | all cause death 1.72 [0.91; 3.24] non fatal stroke 1.74 [0.73; 4.13] non fatal MI 0.65 [0.35; 1.19] CV events 0.88 [0.63; 1.23] | | ORIENT | olmesartan vs placebo | | | all cause death 0.96 [0.52; 1.75] CV death 3.36 [0.93; 12.07] non fatal stroke 0.73 [0.30; 1.79] non fatal MI 0.43 [0.11; 1.65] |
| Trial | Treatments | Patients | Method |
|---|
| ROADMAP, 2010 | olmesartan at 40 mg/day (n=2232) vs. placebo (n=2215) | patients with diabetes and at least one additional cardiovascular risk factor, but no evidence of renal dysfunction | double-blind Parallel groups Sample size: 2232/2215 Primary endpoint: microalbuminuria FU duration: 3.2 y | | ORIENT | olmesartan (n=282) vs. placebo (n=284) | patients with diabetic Nephropathy and overt proteinuria secondary to type 2 diabetes mellitus | double-blind Parallel groups Sample size: 282/284 Primary endpoint: FU duration: |
|
| miscellaneous | ramipril | not classified | versus No demonstrated result for efficacy telmisartan + ramipril inferior to ramipril in terms of Insuffisance rénale in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to ramipril in terms of hypotension in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to ramipril in terms of Arrêt pour effet secondaire in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to telmisartan in terms of Insuffisance rénale in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of Toux in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of hypotension in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of Arrêt pour effet secondaire in ONTARGET (association vs telmisartan), 2008 | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ONTARGET (association vs ramipril), 2008 | telmisartan + ramipril vs ramipril | | Insuffisance rénale 1.58 [1.14; 2.18] hypotension 2.75 [2.28; 3.31] Arrêt pour effet secondaire 1.20 [1.14; 1.26] | Crit principaux 0.99 [0.93; 1.06] nouveau diabète 0.89 [0.77; 1.03] Mortalité totale 1.06 [0.98; 1.15] Ev. coronariens 1.07 [0.94; 1.22] Décès cardiovasculaires 1.04 [0.93; 1.16] revascularisation 1.04 [0.96; 1.11] AVC mortels et non mortels 0.93 [0.81; 1.07] Toux 1.10 [0.96; 1.26] Ev. cardiovasculaires 1.00 [0.93; 1.08] Angiodème 0.73 [0.40; 1.33] | | ONTARGET (association vs telmisartan), 2008 | telmisartan + ramipril vs telmisartan | nouveau diabète 0.81 [0.70; 0.94] | Insuffisance rénale 1.39 [1.02; 1.89] Toux 4.23 [3.38; 5.30] hypotension 1.78 [1.52; 2.09] Arrêt pour effet secondaire 1.28 [1.21; 1.34] | Crit principaux 0.98 [0.91; 1.05] Mortalité totale 1.08 [1.00; 1.17] Ev. coronariens 1.00 [0.88; 1.14] Décès cardiovasculaires 1.04 [0.93; 1.16] revascularisation 1.01 [0.95; 1.09] AVC mortels et non mortels 1.02 [0.88; 1.17] Ev. cardiovasculaires 1.01 [0.94; 1.09] Angiodème 1.81 [0.84; 3.92] |
| Trial | Treatments | Patients | Method |
|---|
| ONTARGET (association vs ramipril), 2008 | telmisartan 80mg + ramipril 10mg daily (n=8502) vs. ramipril 10 mg daily
(n=8576)
| patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage
| double blind Parallel groups Sample size: 8502/8576 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y
| | ONTARGET (association vs telmisartan), 2008 | telmisartan 80mg + ramipril 10mg daily
(n=8502) vs. telmisartan 80 mg daily (n=8542)
| patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage
| double blind Parallel groups Sample size: 8502/8542 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y
|
|
| miscellaneous | telmisartan | not classified | versus placebo or control No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| TRANSCEND, 2008 | telmisartan vs placebo | Ev. cardiovasculaires 0.88 [0.77; 1.00] HOPE endpoint 0.88 [0.77; 1.00] | | cancer occurence 1.16 [0.97; 1.39] cancer occurence (as prespecified endpoint) 1.16 [0.97; 1.39] Crit principaux 0.93 [0.83; 1.04] Insuffisance rénale 1.86 [0.95; 3.64] Mortalité totale 1.05 [0.91; 1.20] Ev. coronariens 0.79 [0.63; 1.01] Décès cardiovasculaires 1.02 [0.86; 1.22] revascularisation 0.90 [0.79; 1.03] AVC mortels et non mortels 0.83 [0.65; 1.06] Toux 0.84 [0.42; 1.66] hypotension 1.82 [0.99; 3.35] Arrêt pour effet secondaire 0.91 [0.83; 1.00] Angiodème 0.67 [0.11; 4.01] | | PROPHESS, 2008 | telmisartan vs placebo | | | cardiovascular death 0.85 [0.71; 1.02] cancer occurence 0.96 [0.83; 1.12] all cause death 1.02 [0.93; 1.13] Cardiovascular death 0.85 [0.71; 1.02] cancer 0.96 [0.83; 1.12] stroke (fatal and non fatal) 0.95 [0.87; 1.03] Myocardial infarction ( fatal and non fatal) 1.00 [0.81; 1.23] cardiovascular event 0.94 [0.88; 1.01] New onset diabetes 0.83 [0.66; 1.05] lung cancer 1.24 [0.77; 2.00] |
| Trial | Treatments | Patients | Method |
|---|
| TRANSCEND, 2008 | telmisartan 80 mg/day (n=2954) vs. placebo (n=2972) | high-risk patients intolerant to
angiotensin-converting enzyme inhibitors | double blind Parallel groups Sample size: 2954/2972 Primary endpoint: CV death, MI, stroke, hospitalization for HF FU duration: median 56 months (IQR 51-64) | | PROPHESS, 2008 | telmisartan 80 mg daily (n=10146) vs. placebo (n=10186) | patients who recently had an ischemic stroke | double blind Factorial plan Sample size: 10146/10186 Primary endpoint: recurrent stroke FU duration: 2.5 y |
|
| miscellaneous | telmisartan | not classified | versus No demonstrated result for efficacy telmisartan inferior to ramipril in terms of hypotension in ONTARGET (telmisartan alone), 2008 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ONTARGET (telmisartan alone), 2008 | telmisartan vs ramipril | Toux 0.26 [0.21; 0.33] Arrêt pour effet secondaire 0.94 [0.89; 0.99] Angiodème 0.40 [0.19; 0.84] | hypotension 1.54 [1.26; 1.89] | Crit principaux 1.01 [0.95; 1.08] nouveau diabète 1.09 [0.95; 1.26] Insuffisance rénale 1.14 [0.81; 1.61] Mortalité totale 0.98 [0.90; 1.06] Ev. coronariens 1.07 [0.94; 1.22] Décès cardiovasculaires 1.00 [0.89; 1.11] revascularisation 1.02 [0.95; 1.10] AVC mortels et non mortels 0.91 [0.80; 1.05] Ev. cardiovasculaires 0.99 [0.92; 1.06] |
| Trial | Treatments | Patients | Method |
|---|
| ONTARGET (telmisartan alone), 2008 | telmisartan 80mg daily (n=8542) vs. ramipril 10 mg daily (n=8576) | patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage | double blind Parallel groups Sample size: 8542/8576 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y |
|
| patients at high risk for cardiovascular events | candesartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| SCOPE, 2003 | candesartan vs placebo | | | cardiovascular death 0.95 [0.76; 1.18] all cause death 0.97 [0.82; 1.14] coronary event 1.10 [0.79; 1.54] Cardiovascular death 0.95 [0.76; 1.18] cancer 1.08 [0.89; 1.31] stroke (fatal and non fatal) 0.77 [0.59; 1.01] Myocardial infarction ( fatal and non fatal) 1.10 [0.79; 1.54] cardiac death 0.99 [0.52; 1.90] cardiovascular event 0.90 [0.76; 1.06] New onset diabetes 0.80 [0.63; 1.03] |
| Trial | Treatments | Patients | Method |
|---|
| SCOPE, 2003 | candesartan, 8–16 mg once daily (target 160/90) (n=2477) vs. placebo (n=2460) | patients aged 70–89 years, with systolic blood pressure 160– 179 mmHg, and/or diastolic blood pressure 90–99 mmHg, and a Mini Mental State Examination (MMSE) test score > 24 | double-blind Parallel groups Sample size: 2477/2460 Primary endpoint: major cardiovascular events FU duration: 3.7 y (mean) |
|
| patients at high risk for cardiovascular events | losartan | not classified | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| RENAAL, 2001 | losartan vs placebo | | | |
| Trial | Treatments | Patients | Method |
|---|
| RENAAL, 2001 | lLosartan 50 to 100 mg once daily (n=751) vs. placebo (n=762) | patients with type 2 diabetes and nephropathy | double-blind Parallel groups Sample size: 751/762 Primary endpoint: doubling of the base-line serum creatinine concentration, end-stage renal disease, or death FU duration: 3.4 years |
|
| patients at high risk for cardiovascular events | losartan | not classified | versus beta-blockers No demonstrated result for efficacy losartan inferior to atenolol in terms of PAD inférieure à 90 in LIFE, 2002 losartan inferior to atenolol in terms of lung cancer in LIFE, 2002 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| LIFE, 2002 | losartan vs atenolol | apparition d'un premier évènement cardiovasculaire 0.86 [0.77; 0.96] PAS inférieure à 140 1.08 [1.03; 1.12] PA inférieure à140/90 1.07 [1.02; 1.11] stroke (fatal and non fatal) 0.75 [0.63; 0.88] cardiovascular event 0.86 [0.77; 0.96] New onset diabetes 0.75 [0.64; 0.89] | PAD inférieure à 90 0.98 [0.97; 1.00] lung cancer 2.41 [1.23; 4.71] | cardiovascular death 0.87 [0.72; 1.04] cancer occurence(prespecified endpoint) 1.11 [0.96; 1.29] cancer occurence 1.11 [0.96; 1.29] all cause death 0.89 [0.78; 1.01] coronary event 1.05 [0.86; 1.28] Cardiovascular death 0.87 [0.72; 1.04] Heart failure 0.95 [0.76; 1.18] cancer 1.11 [0.96; 1.29] Myocardial infarction ( fatal and non fatal) 1.05 [0.86; 1.28] cancer death 1.03 [0.80; 1.34] |
| Trial | Treatments | Patients | Method |
|---|
| LIFE, 2002 | losartan (n=4605) vs. atenolol (n=4588) | patients aged 55–80 years, with previously treated or untreated hypertension (sitting blood pressure 160–200/95–115 mm Hg) and ECG signs of LVH. | Double blind Parallel groups Sample size: 4605/4588 Primary endpoint: Cardiovascular mortality, stroke, and myocardial infarction FU duration: 4.8 y (mean) |
|
| patients at high risk for cardiovascular events | ramipril | not classified | versus No demonstrated result for efficacy telmisartan + ramipril inferior to ramipril in terms of Insuffisance rénale in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to ramipril in terms of hypotension in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to ramipril in terms of Arrêt pour effet secondaire in ONTARGET (association vs ramipril), 2008 telmisartan + ramipril inferior to telmisartan in terms of Insuffisance rénale in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of Toux in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of hypotension in ONTARGET (association vs telmisartan), 2008 telmisartan + ramipril inferior to telmisartan in terms of Arrêt pour effet secondaire in ONTARGET (association vs telmisartan), 2008 | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ONTARGET (association vs ramipril), 2008 | telmisartan + ramipril vs ramipril | | Insuffisance rénale 1.58 [1.14; 2.18] hypotension 2.75 [2.28; 3.31] Arrêt pour effet secondaire 1.20 [1.14; 1.26] | Crit principaux 0.99 [0.93; 1.06] nouveau diabète 0.89 [0.77; 1.03] Mortalité totale 1.06 [0.98; 1.15] Ev. coronariens 1.07 [0.94; 1.22] Décès cardiovasculaires 1.04 [0.93; 1.16] revascularisation 1.04 [0.96; 1.11] AVC mortels et non mortels 0.93 [0.81; 1.07] Toux 1.10 [0.96; 1.26] Ev. cardiovasculaires 1.00 [0.93; 1.08] Angiodème 0.73 [0.40; 1.33] | | ONTARGET (association vs telmisartan), 2008 | telmisartan + ramipril vs telmisartan | nouveau diabète 0.81 [0.70; 0.94] | Insuffisance rénale 1.39 [1.02; 1.89] Toux 4.23 [3.38; 5.30] hypotension 1.78 [1.52; 2.09] Arrêt pour effet secondaire 1.28 [1.21; 1.34] | Crit principaux 0.98 [0.91; 1.05] Mortalité totale 1.08 [1.00; 1.17] Ev. coronariens 1.00 [0.88; 1.14] Décès cardiovasculaires 1.04 [0.93; 1.16] revascularisation 1.01 [0.95; 1.09] AVC mortels et non mortels 1.02 [0.88; 1.17] Ev. cardiovasculaires 1.01 [0.94; 1.09] Angiodème 1.81 [0.84; 3.92] |
| Trial | Treatments | Patients | Method |
|---|
| ONTARGET (association vs ramipril), 2008 | telmisartan 80mg + ramipril 10mg daily (n=8502) vs. ramipril 10 mg daily
(n=8576)
| patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage
| double blind Parallel groups Sample size: 8502/8576 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y
| | ONTARGET (association vs telmisartan), 2008 | telmisartan 80mg + ramipril 10mg daily
(n=8502) vs. telmisartan 80 mg daily (n=8542)
| patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage
| double blind Parallel groups Sample size: 8502/8542 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y
|
|
| patients at high risk for cardiovascular events | telmisartan | not classified | versus placebo or control No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| TRANSCEND, 2008 | telmisartan vs placebo | Ev. cardiovasculaires 0.88 [0.77; 1.00] HOPE endpoint 0.88 [0.77; 1.00] | | cancer occurence 1.16 [0.97; 1.39] cancer occurence (as prespecified endpoint) 1.16 [0.97; 1.39] Crit principaux 0.93 [0.83; 1.04] Insuffisance rénale 1.86 [0.95; 3.64] Mortalité totale 1.05 [0.91; 1.20] Ev. coronariens 0.79 [0.63; 1.01] Décès cardiovasculaires 1.02 [0.86; 1.22] revascularisation 0.90 [0.79; 1.03] AVC mortels et non mortels 0.83 [0.65; 1.06] Toux 0.84 [0.42; 1.66] hypotension 1.82 [0.99; 3.35] Arrêt pour effet secondaire 0.91 [0.83; 1.00] Angiodème 0.67 [0.11; 4.01] | | PROPHESS, 2008 | telmisartan vs placebo | | | cardiovascular death 0.85 [0.71; 1.02] cancer occurence 0.96 [0.83; 1.12] all cause death 1.02 [0.93; 1.13] Cardiovascular death 0.85 [0.71; 1.02] cancer 0.96 [0.83; 1.12] stroke (fatal and non fatal) 0.95 [0.87; 1.03] Myocardial infarction ( fatal and non fatal) 1.00 [0.81; 1.23] cardiovascular event 0.94 [0.88; 1.01] New onset diabetes 0.83 [0.66; 1.05] lung cancer 1.24 [0.77; 2.00] |
| Trial | Treatments | Patients | Method |
|---|
| TRANSCEND, 2008 | telmisartan 80 mg/day (n=2954) vs. placebo (n=2972) | high-risk patients intolerant to
angiotensin-converting enzyme inhibitors | double blind Parallel groups Sample size: 2954/2972 Primary endpoint: CV death, MI, stroke, hospitalization for HF FU duration: median 56 months (IQR 51-64) | | PROPHESS, 2008 | telmisartan 80 mg daily (n=10146) vs. placebo (n=10186) | patients who recently had an ischemic stroke | double blind Factorial plan Sample size: 10146/10186 Primary endpoint: recurrent stroke FU duration: 2.5 y |
|
| patients at high risk for cardiovascular events | telmisartan | not classified | versus No demonstrated result for efficacy telmisartan inferior to ramipril in terms of hypotension in ONTARGET (telmisartan alone), 2008 | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| ONTARGET (telmisartan alone), 2008 | telmisartan vs ramipril | Toux 0.26 [0.21; 0.33] Arrêt pour effet secondaire 0.94 [0.89; 0.99] Angiodème 0.40 [0.19; 0.84] | hypotension 1.54 [1.26; 1.89] | Crit principaux 1.01 [0.95; 1.08] nouveau diabète 1.09 [0.95; 1.26] Insuffisance rénale 1.14 [0.81; 1.61] Mortalité totale 0.98 [0.90; 1.06] Ev. coronariens 1.07 [0.94; 1.22] Décès cardiovasculaires 1.00 [0.89; 1.11] revascularisation 1.02 [0.95; 1.10] AVC mortels et non mortels 0.91 [0.80; 1.05] Ev. cardiovasculaires 0.99 [0.92; 1.06] |
| Trial | Treatments | Patients | Method |
|---|
| ONTARGET (telmisartan alone), 2008 | telmisartan 80mg daily (n=8542) vs. ramipril 10 mg daily (n=8576) | patients patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage | double blind Parallel groups Sample size: 8542/8576 Primary endpoint: cardiovascular events or hospitalization for HF FU duration: 4.7y |
|
