Comparison of once-daily versus twice-daily dosing of valsartan in patients with chronic stable heart failure

Inder Anand, Anita Deswal, Dean J. Kereiakes, Das Purkayastha, Dion H. Zappe

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The safety of once-daily (qd) dosing of valsartan in heart failure (HF) patients is not known. Hypothesis: This 10-week, double-blind trial examined the relative safety and efficacy of valsartan administered qd versus twice-daily (bid). Methods: HF patients (NYHA class II-III) receiving diuretics (87%), angiotensin-converting enzyme inhibitors (98%), beta-blockers (92%), aldosterone antagonists (25%), or digoxin (32%) were randomized to valsartan 40 mg bid (n = 60) or 80 mg qd (n = 55) and titrated to a maximum dose of 320 mg/day; doubling the dose every 2 weeks. Clinical and biochemical parameters were measured at Weeks 2, 4, 6, and 10. Results: The average dose of valsartan at the end of study was 245 mg in the bid group vs 256 mg in the qd group (P = NS). Similar proportions of patients tolerated qd vs bid dosing (bid 67% vs qd 68%). Outcome measures including reduction in blood pressure, incidence of hypotension, renal impairment, orthostatic dizziness or fatigue, changes in serum K+, creatinine, cystatin-C, and estimated glomerular filtration rate were similar between the 2 groups at all time-points. Brain natriuretic peptide levels decreased and plasma renin activity increased from baseline by the same amount in both groups at all time-points. Conclusion: Valsartan administered qd has a similar safety and tolerability profile with comparable 24-hour RAAS blockade, as assessed by increases in PRA, as bid dosing in patients with moderate to severe (NYHA class II-III) heart failure.

Original languageEnglish (US)
Pages (from-to)449-455
Number of pages7
JournalVascular Health and Risk Management
Volume6
Issue number1
StatePublished - Dec 1 2010
Externally publishedYes

Fingerprint

Valsartan
Heart Failure
Safety
Mineralocorticoid Receptor Antagonists
Cystatin C
Brain Natriuretic Peptide
Digoxin
Dizziness
Glomerular Filtration Rate
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Renin
Hypotension
Fatigue
Creatinine
Outcome Assessment (Health Care)
Blood Pressure
Kidney
Incidence

Keywords

  • Angiotensin receptor blocker
  • Heart failure
  • Valsartan

Cite this

Anand, I., Deswal, A., Kereiakes, D. J., Purkayastha, D., & Zappe, D. H. (2010). Comparison of once-daily versus twice-daily dosing of valsartan in patients with chronic stable heart failure. Vascular Health and Risk Management, 6(1), 449-455.

Comparison of once-daily versus twice-daily dosing of valsartan in patients with chronic stable heart failure. / Anand, Inder; Deswal, Anita; Kereiakes, Dean J.; Purkayastha, Das; Zappe, Dion H.

In: Vascular Health and Risk Management, Vol. 6, No. 1, 01.12.2010, p. 449-455.

Research output: Contribution to journalArticle

Anand, I, Deswal, A, Kereiakes, DJ, Purkayastha, D & Zappe, DH 2010, 'Comparison of once-daily versus twice-daily dosing of valsartan in patients with chronic stable heart failure', Vascular Health and Risk Management, vol. 6, no. 1, pp. 449-455.
Anand, Inder ; Deswal, Anita ; Kereiakes, Dean J. ; Purkayastha, Das ; Zappe, Dion H. / Comparison of once-daily versus twice-daily dosing of valsartan in patients with chronic stable heart failure. In: Vascular Health and Risk Management. 2010 ; Vol. 6, No. 1. pp. 449-455.
@article{75993e0afc3344a1b1f49ada6bf4088c,
title = "Comparison of once-daily versus twice-daily dosing of valsartan in patients with chronic stable heart failure",
abstract = "Background: The safety of once-daily (qd) dosing of valsartan in heart failure (HF) patients is not known. Hypothesis: This 10-week, double-blind trial examined the relative safety and efficacy of valsartan administered qd versus twice-daily (bid). Methods: HF patients (NYHA class II-III) receiving diuretics (87{\%}), angiotensin-converting enzyme inhibitors (98{\%}), beta-blockers (92{\%}), aldosterone antagonists (25{\%}), or digoxin (32{\%}) were randomized to valsartan 40 mg bid (n = 60) or 80 mg qd (n = 55) and titrated to a maximum dose of 320 mg/day; doubling the dose every 2 weeks. Clinical and biochemical parameters were measured at Weeks 2, 4, 6, and 10. Results: The average dose of valsartan at the end of study was 245 mg in the bid group vs 256 mg in the qd group (P = NS). Similar proportions of patients tolerated qd vs bid dosing (bid 67{\%} vs qd 68{\%}). Outcome measures including reduction in blood pressure, incidence of hypotension, renal impairment, orthostatic dizziness or fatigue, changes in serum K+, creatinine, cystatin-C, and estimated glomerular filtration rate were similar between the 2 groups at all time-points. Brain natriuretic peptide levels decreased and plasma renin activity increased from baseline by the same amount in both groups at all time-points. Conclusion: Valsartan administered qd has a similar safety and tolerability profile with comparable 24-hour RAAS blockade, as assessed by increases in PRA, as bid dosing in patients with moderate to severe (NYHA class II-III) heart failure.",
keywords = "Angiotensin receptor blocker, Heart failure, Valsartan",
author = "Inder Anand and Anita Deswal and Kereiakes, {Dean J.} and Das Purkayastha and Zappe, {Dion H.}",
year = "2010",
month = "12",
day = "1",
language = "English (US)",
volume = "6",
pages = "449--455",
journal = "Vascular Health and Risk Management",
issn = "1176-6344",
publisher = "Dove Medical Press Ltd.",
number = "1",

}

TY - JOUR

T1 - Comparison of once-daily versus twice-daily dosing of valsartan in patients with chronic stable heart failure

AU - Anand, Inder

AU - Deswal, Anita

AU - Kereiakes, Dean J.

AU - Purkayastha, Das

AU - Zappe, Dion H.

PY - 2010/12/1

Y1 - 2010/12/1

N2 - Background: The safety of once-daily (qd) dosing of valsartan in heart failure (HF) patients is not known. Hypothesis: This 10-week, double-blind trial examined the relative safety and efficacy of valsartan administered qd versus twice-daily (bid). Methods: HF patients (NYHA class II-III) receiving diuretics (87%), angiotensin-converting enzyme inhibitors (98%), beta-blockers (92%), aldosterone antagonists (25%), or digoxin (32%) were randomized to valsartan 40 mg bid (n = 60) or 80 mg qd (n = 55) and titrated to a maximum dose of 320 mg/day; doubling the dose every 2 weeks. Clinical and biochemical parameters were measured at Weeks 2, 4, 6, and 10. Results: The average dose of valsartan at the end of study was 245 mg in the bid group vs 256 mg in the qd group (P = NS). Similar proportions of patients tolerated qd vs bid dosing (bid 67% vs qd 68%). Outcome measures including reduction in blood pressure, incidence of hypotension, renal impairment, orthostatic dizziness or fatigue, changes in serum K+, creatinine, cystatin-C, and estimated glomerular filtration rate were similar between the 2 groups at all time-points. Brain natriuretic peptide levels decreased and plasma renin activity increased from baseline by the same amount in both groups at all time-points. Conclusion: Valsartan administered qd has a similar safety and tolerability profile with comparable 24-hour RAAS blockade, as assessed by increases in PRA, as bid dosing in patients with moderate to severe (NYHA class II-III) heart failure.

AB - Background: The safety of once-daily (qd) dosing of valsartan in heart failure (HF) patients is not known. Hypothesis: This 10-week, double-blind trial examined the relative safety and efficacy of valsartan administered qd versus twice-daily (bid). Methods: HF patients (NYHA class II-III) receiving diuretics (87%), angiotensin-converting enzyme inhibitors (98%), beta-blockers (92%), aldosterone antagonists (25%), or digoxin (32%) were randomized to valsartan 40 mg bid (n = 60) or 80 mg qd (n = 55) and titrated to a maximum dose of 320 mg/day; doubling the dose every 2 weeks. Clinical and biochemical parameters were measured at Weeks 2, 4, 6, and 10. Results: The average dose of valsartan at the end of study was 245 mg in the bid group vs 256 mg in the qd group (P = NS). Similar proportions of patients tolerated qd vs bid dosing (bid 67% vs qd 68%). Outcome measures including reduction in blood pressure, incidence of hypotension, renal impairment, orthostatic dizziness or fatigue, changes in serum K+, creatinine, cystatin-C, and estimated glomerular filtration rate were similar between the 2 groups at all time-points. Brain natriuretic peptide levels decreased and plasma renin activity increased from baseline by the same amount in both groups at all time-points. Conclusion: Valsartan administered qd has a similar safety and tolerability profile with comparable 24-hour RAAS blockade, as assessed by increases in PRA, as bid dosing in patients with moderate to severe (NYHA class II-III) heart failure.

KW - Angiotensin receptor blocker

KW - Heart failure

KW - Valsartan

UR - http://www.scopus.com/inward/record.url?scp=79952055578&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952055578&partnerID=8YFLogxK

M3 - Article

C2 - 20730060

AN - SCOPUS:79952055578

VL - 6

SP - 449

EP - 455

JO - Vascular Health and Risk Management

JF - Vascular Health and Risk Management

SN - 1176-6344

IS - 1

ER -