Diovan med
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Summary
8 papers analyzed
These studies suggest Diovan (valsartan) effectively lowers blood pressure, treats congestive heart failure, and reduces mortality after myocardial infarction, with good tolerability and safety.
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Diovan (Valsartan) in Hypertension and Heart Failure Management
Introduction to Diovan (Valsartan)
Diovan, known generically as valsartan, is an angiotensin II receptor blocker (ARB) used primarily for the treatment of hypertension and heart failure. It works by inhibiting the effects of angiotensin II, a hormone that causes blood vessels to constrict, thereby lowering blood pressure and reducing the workload on the heart .
Effectiveness in Severe Arterial Hypertension
Diovan has been shown to be effective in the management of severe arterial hypertension when used in combination with other antihypertensive agents such as clofelin, beta-blockers, ACE inhibitors, and diuretics. In a study involving 15 patients, 80% achieved satisfactory blood pressure levels with Diovan, although 13.3% did not respond, and 6.7% had to discontinue due to allergic reactions. This indicates that while Diovan is generally effective, patient response can vary.
Role in Heart Failure and Post-Myocardial Infarction
Valsartan has demonstrated significant benefits in patients with chronic heart failure (CHF) and those with left ventricular systolic dysfunction (LVSD) following an acute myocardial infarction (MI). The VALIANT trial found that valsartan was as effective as captopril in reducing mortality and cardiovascular morbidity in these high-risk patients. However, combining valsartan with captopril did not provide additional benefits and was less well tolerated. This suggests that valsartan alone is a viable option for managing heart failure and post-MI patients.
Combination Therapy with Hydrochlorothiazide
For patients with hypertension, combination therapy is often necessary to achieve target blood pressure levels. Diovan is frequently combined with hydrochlorothiazide (HCT), a diuretic, to enhance its antihypertensive effects. Studies have shown that the fixed combination of valsartan and HCT is more effective in controlling blood pressure than valsartan alone, achieving control in approximately 70% of cases . This combination therapy is particularly beneficial for patients who do not respond adequately to monotherapy.
Safety and Tolerability
Diovan is generally well tolerated, with a good safety profile. In studies, most patients did not experience significant side effects, and those that did were typically mild, such as headaches . Additionally, valsartan has not been associated with an increased risk of adverse cardiovascular outcomes, countering earlier concerns about its safety.
Regulatory and Ethical Considerations
Despite its clinical benefits, valsartan has faced regulatory scrutiny. In Japan, Novartis was prosecuted for allegedly using falsified research data to promote Diovan to doctors, highlighting the importance of ethical practices in pharmaceutical marketing.
Conclusion
Diovan (valsartan) is a potent ARB effective in managing hypertension and heart failure, particularly when used in combination with other antihypertensive agents. It has a favorable safety profile and is well tolerated by most patients. However, ethical considerations in its promotion underscore the need for integrity in clinical research and marketing practices.
Sources and full results
Most relevant research papers on this topic
6
[Diovan efficacy and tolerance in mild and moderate hypertension].
6
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1999
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The CEO of Novartis on growing after a patent cliff.
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2012