The angiotensin receptor blocker, eprosartan, is associated with fewer adverse cardiovascular/cerebrovascular events, compared with the calcium antagonist, nitrendipine, in hypertensive patients with a recent history of stroke, Hans-Christian Diener, MD, said.
In the Morbidity and Mortality after Stroke (MOSES) trial, the agents were compared as secondary stroke prophylaxis in 1,405 hypertensive patients (mean age: 68 years) who had suffered a cerebral event in the preceding 24 months. Patients were randomized to eprosartan, 600 mg/d, or nitrendipine, 10 mg/d.
During the 2.5-year follow-up, achieved blood pressures were comparable between the two groups: mean blood pressure in patients randomized to eprosartan decreased from 150.7/84 mm Hg at baseline to 137.5/80.8 mm Hg at the final follow-up; mean blood pressure in patients assigned to nitrendipine declined from 152.0/87.2 mm Hg to 136.0/80.2 mm Hg.
The primary endpoint--the composite of total mortality and all cardiac and cerebrovascular events--was reached by 206 patients assigned to eprosartan and 255 assigned to nitrendipine, corresponding to a 21% reduction with eprosartan (p=0.014). This was the first clinical trial in secondary stroke prevention to compare two active treatments, noted Dr. Diener, chairman and professor of neurology, University of Essen, Germany.
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