Olmesartan 20 mg equivalent to losartan
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Comparative Efficacy of Olmesartan 20 mg and Losartan 50 mg in Hypertension Management
Introduction to Angiotensin Receptor Blockers (ARBs)
Angiotensin receptor blockers (ARBs) are a class of medications commonly used to manage hypertension. Among these, olmesartan and losartan are frequently prescribed. Understanding the comparative efficacy of these drugs is crucial for optimizing hypertension treatment.
Olmesartan 20 mg vs. Losartan 50 mg: Blood Pressure Reduction
Efficacy in Reducing Diastolic Blood Pressure (DBP)
Several studies have demonstrated that olmesartan 20 mg is more effective than losartan 50 mg in reducing diastolic blood pressure (DBP). In a randomized, double-blind study, olmesartan 20 mg showed a significantly greater reduction in seated DBP compared to losartan 50 mg after 8 weeks of treatment1 3 4. Specifically, olmesartan reduced DBP by 11.5 mm Hg, whereas losartan reduced it by 8.2 mm Hg4.
Efficacy in Reducing Systolic Blood Pressure (SBP)
Olmesartan also demonstrated superior efficacy in reducing systolic blood pressure (SBP). In a comparative study, olmesartan 20 mg reduced SBP by 12.5 mm Hg, while losartan 50 mg achieved a reduction of 9.0 mm Hg4. Another study confirmed that olmesartan 20 mg was more effective than losartan 50 mg in lowering both DBP and SBP over an 8-week period5.
Achievement of Blood Pressure Goals
Proportion of Patients Reaching Target BP
A higher proportion of patients treated with olmesartan 20 mg achieved the target blood pressure of <140/90 mm Hg compared to those treated with losartan 50 mg. In one study, 65.3% of patients in the olmesartan group reached the target BP after 4 weeks, compared to 52.7% in the losartan group5. This trend continued at the 8-week mark, with olmesartan showing a higher efficacy in achieving BP goals3.
Safety and Tolerability
Adverse Events
Both olmesartan and losartan were well-tolerated, with similar incidences of adverse events. Most side effects were mild and transient, with no significant differences between the two drugs5 9. This indicates that both medications are safe for long-term use in managing hypertension.
Conclusion
In summary, olmesartan 20 mg is generally more effective than losartan 50 mg in reducing both diastolic and systolic blood pressure in patients with hypertension. Additionally, a higher proportion of patients achieve their target blood pressure with olmesartan. Both medications are well-tolerated, making them viable options for hypertension management. However, olmesartan may offer superior efficacy, particularly in patients who require more substantial blood pressure reductions.
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Most relevant research papers on this topic
Comparison of Increasing Doses of Olmesartan Medoxomil, Losartan Potassium, and Valsartan in Patients With Essential Hypertension
Olmesartan medoxomil effectively reduces blood pressure more than losartan potassium and valsartan, but all three angiotensin receptor blockers effectively lower blood pressure.
RCT
Highly Cited[PP.36.05] EXPRESSION AND CHANGE IN MIRS 145, 221 AND 222 EXPRESSION IN HYPERTENSIVE SUBJECTS TREATED WITH ENALAPRIL, LOSARTAN OR OLMESARTAN
Enalapril, losartan, and olmesartan effectively lower blood pressure and improve lipid profile, while reducing microRNA expression in monocytes involved in vasculature homeostasis and damage.
RCT
Very Rigorous JournalA Randomized, Double-Blind, Forced-Titration Study to Compare Olmesartan Medoxomil versus Losartan Potassium in Patients with Stage 1 and 2 Hypertension
Olmesartan medoxomil effectively reduces blood pressure more effectively than losartan potassium, leading to more patients achieving their blood pressure goals with similar tolerability.
RCT
Large Human TrialComparative Efficacy of Olmesartan, Losartan, Valsartan, and Irbesartan in the Control of Essential Hypertension
Olmesartan, at its starting dose, is more effective than other ARBs in reducing cuff diastolic blood pressure in patients with essential hypertension.
RCTLarge Human TrialHighly Cited[Efficacy and safety of olmesartan medoxomil versus losartan potassium in Chinese patients with mild to moderate essential hypertension].
Olmesartan medoxomil, at 20 mg-40 mg once daily, is effective and safe for treating mild to moderate essential hypertension, with a more durable hypotensive effect than losartan potassium.
RCTOlmesartan compared with other angiotensin II receptor antagonists: head-to-head trials.
Olmesartan is more effective than other angiotensin II receptor antagonists at recommended doses in reducing blood pressure in patients with essential hypertension.
Efficacy and Tolerability of Olmesartan, Telmisartan, and Losartan in Patients of Stage I Hypertension: A Randomized, Open-label Study
Olmesartan is the most effective in reducing blood pressure, while telmisartan and losartan show equal efficacy, with telmisartan showing the most favorable effects on fasting blood glucose and lipid profile.
RCTEfficacy and safety of domestic olmesartan in treatment of mild to moderate essential hypertension
Domestic olmesartan is an effective, safe, and long-acting treatment for mild to moderate essential hypertension, with no significant difference in effectiveness or adverse effects compared to losartan.
RCTInitial combination therapy with olmesartan/hydrochlorothiazide in moderate-to-severe hypertension
Olmesartan medoxomil 20 mg/hydrochlorothiazide 12.5 mg effectively reduces blood pressure in patients with moderate-to-severe hypertension compared to losartan 50mg/HCTZ 12.5 mg.
RCTLarge Human Trial
Rigorous Journal