Latest research on Valsartan

Valsartan is an angiotensin-receptor blocker (ARB) that may be used to treat a variety of cardiac conditions including hypertension, diabetic nephropathy and heart failure. Valsartan lowers blood pressure by antagonizing the renin-angiotensin-aldosterone system (RAAS); it competes with angiotensin II for binding to the type-1 angiotensin II receptor (AT1) subtype and prevents the blood pressure increasing effects of angiotensin II. Unlike angiotensin-converting enzyme (ACE) inhibitors, ARBs do not have the adverse effect of dry cough. Valsartan may be used to treat hypertension, isolated systolic hypertension, left ventricular hypertrophy and diabetic nephropathy. It may also be used as an alternative agent for the treatment of heart failure, systolic dysfunction, myocardial infarction and coronary artery disease.

Latest findings

Two such trials – the Losartan Heart Failure Survival Study (ELITE II) and the Valsartan Heart Failure Trial (Val-HeFT) – are reviewed below. [source, 2001]
In contrast, the primary hypothesis in Val-HeFT was that Valsartan in addition to an ACE inhibitor would improve mortality as compared to placebo (i.e. that the combination with an angiotensin II antagonist would be better than an ACE inhibitor alone). [source, 2001]
Val-HeFT randomised and titrated patients to placebo or relatively high doses of Valsartan (160 mg, twice daily), in patients tolerating chronic treatment with an ACE inhibitor. [source, 2001]
This permits comparison between Valsartan (as monotherapy) and placebo. [source, 2001]
In the Val-HeFT study, in the subgroup (n = 1606; 32%) treated with both an ACE inhibitor and a beta-blocker, a trend favouring placebo was observed (risk increase 15% for Valsartan versus placebo, RR 1.185, 95% CI 0.969–1.450). [source, 2001]
Further, this issue is being adequately addressed by the large number of patients receiving beta-blockers for secondary prophylaxis following myocardial infarction, and randomised to the combination arm of Valsartan plus Captopril in the Valsartan in Acute Myocardial Infarction Trial (VALIANT) [7]. [source, 2001]
In the Val-HeFT study, 9.9% of patients on Valsartan, vs 7.2% on placebo, discontinued taking the study medication due to adverse experiences (P < 0.05). [source, 2001]
The data with Valsartan are particularly encouraging. [source, 2001]
ELITE II compared Losartan to Captopril in mainly ACE inhibitor naïve patients whereas Val-HeFT compared Valsartan to placebo in patients tolerating long-term treatment with an ACE inhibitor. [source, 2001]
The Val-HeFT study suggests that Valsartan added to an ACE inhibitor does not improve survival. [source, 2001]