Based on an extrapolation of these guidelines, patients were also included if they were taking irbesartan 75 mg once daily and were switched to either valsartan 40 mg or losartan 25 mg once daily. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies [erratum in 4. Parving HH, Lehnert H, Brochner-Mortensen J, Gomis R, Andersen S, Arner P; Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria Study Group. Pfeffer MA, Swedberg K, Granger CB, et al; CHARM Investigators and Committees. Hypertension. The hypothesis of this study was that valsartan 80 mg or losartan 50 mg once daily provided BP control similar to that provided by irbesartan 150 mg once daily and that valsartan 160 mg and losartan 100 mg once daily provided BP control similar to that provided by irbesartan 300 mg once daily. **Should valsartan be prescribed for the post-MI indication then specialist advice should be sought. *Prescribers should note that valsartan may be administered twice daily. This study reviewed the cases of patients from Dorn and its outlying community-based outpatient clinics (CBOCs) who made this ARB switch to determine if the new ARB dosing provided BP control equivalent to that of the previously used irbesartan regimen. 2019 May;188(2):481-488. doi: 10.1007/s11845-018-1859-1. Epub 2018 Jul 3. 6. The generalizability of these results also may be limited, as the study was restricted to a small, mostly male population of veterans. No adverse events were recognized in all patients. Seventy-eight mild to moderate hypertensive patients, who were treated with the standard doses of ARBs except candesartan (losartan, 50 mg; valsartan, 80 mg; telmisartan, 40 mg; or olmesartan, 20 mg), were entered into 12-week treatment period with candesartan 8 mg according to a multicenter, open-label design. Patients with HF were switched to valsartan, and patients with diabetes were switched to losartan. United States Department of Veterans Affairs website. 5. 19. Additionally, it was expected that these switches did not cause significant changes in serum potassium or serum creatinine levels. K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. To determine if the dosing guidelines resulted in equal antihypertensive effectiveness, we carried out a retrospective chart review, examining the cases of 86 patients at the William Jennings Bryan Dorn VA Medical Center in Columbia, South Carolina, who had switched from irbesartan to either losartan or valsartan; 11 of these patients had been taking irbesartan 75 mg once daily and were switched to valsartan 40 mg or losartan 25 mg once daily based on an extrapolation of the guidelines. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. Those taking irbesartan/ hydrochlorothiazide were also excluded from the study, as a change in hydro-chlorothiazide dosing has the potential to affect serum potassium levels. Standards of medical care in diabetes–2007. American Heart Association website. We did not have the ability to standardize the dosing of any additional antihypertensive agents, which may or may not have caused additional changes in BP measurements or in serum creatinine or serum potassium levels. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Both have few side effects and reduce BP and proteinuria quite well. It was also expected that the medication switch would not cause a significant difference in BP control, serum potassium levels, or serum creatinine levels. If no comorbidity was present, the choice of agent was left to the prescriber's discretion. Screening for Hypertension | CTFPHC. 1. ; Both losartan and valsartan are used to treat high blood pressure (hypertension). No statistically significant difference was observed between the BP measurements taken before and after the switch (F [3,209]=.11; ACE inhibitors have been studied in a variety of patient populations, including in patients with HF, CKD, diabetes, chronic stable angina, MI, and stroke.Like ACE inhibitors, ARBs also inhibit angiotensin II, but they exert their effect through direct inhibition of angiotensin II type 1 receptors.Potential adverse effects that may occur with both ACE inhibitors and ARBs include hyperkalemia, kidney insufficiency, angioedema, and orthostatic hypotension.In addition to JNC 7, other national guidelines also describe appropriate therapeutic uses for ACE inhibitors and ARBs.Until 2005, irbesartan was the only ARB available on the VANF. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Unable to load your delegates due to an error In 2005, irbesartan was removed from the formulary and was replaced with valsartan and losartan. Saseen JJ, Carter BL. Epub 2013 Oct 10.Clin Ther. Angiotensin II receptor antagonist criteria for use in veteran patients. 8. Summary Clinician Summary Recommendations (PDF) link ⇲ Systematic Review link ⇲ Tools/Resources. Check with your … ; Losartan is also used to reduce the risk of stroke in … Cohn JN, Tognoni G; Valsartan Heart Failure Trial Investigators.