A Comparison of Valsartan and Captopril in Taiwanese Patients with Essential Hypertension

The safety, tolerability, and antihypertensive efficacy of valsartan and captopril were compared in adult Taiwanese outpatients with mild to moderate essential hypertension. Participants in this open-label study were randomized to receive either valsartan 80 mg once daily or captopril 25 mg twice daily for 8 weeks, with optional titration to valsartan 160 mg or captopril 50 mg after 4 weeks. The primary criterion for tolerability was the incidence of adverse events and the primary efficacy variable was the change in mean sitting diastolic blood pressure (SDBP) from baseline to endpoint. A secondary efficacy variable was the change in mean sitting systolic blood pressure (SSBP). Fewer patients receiving valsartan reported adverse events (80 mg , 51.2%; 160 mg, 27.8%) than patients taking captopril (25 mg, 65.2%; 50 mg, 42.9%). A significant difference (P <.001) was observed in the number of captopril-treated patients reporting drug-related dry cough (30.4%) versus the valsartan-treated patients (2.3% ). No significant difference was noted in mean SDBP and SSBP reductions between valsartan and captopril. We conclude that valsartan 80 or 160 mg is as effective as captopril 25 or 50 mg in reducing blood pressure and has a significantly better tolerability profile