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| |  ASH: Atacand(Candesartan) Effective Antihypertensive, More Tolerable Than Norvasc(Amlodipine) NEW YORK, NY -- May 19, 2000 -- The angiotensin II receptor blocker (ARB) Atacand® (candesartan cilexetil) demonstrated similar efficacy in lowering blood pressure with significantly less swelling in patients' feet and ankles compared to the most prescribed antihypertensive medication, the calcium channel blocker Norvasc® (amlodipine, Pfizer), according to findings from the CASTLE (Candesartan Amlodipine Study of TolerabiLity and Efficacy) Study. Investigators presented their research during the Fifteenth Scientific Meeting of the American Society of Hypertension. In the eight-week, double-blind, parallel study, 251 adult patients (45 percent female, 16 percent black) with mild hypertension (90 to 99 mmHg diastolic blood pressure) were randomized to receive either once-daily candesartan cilexetil 16 mg, or amlodipine 5 mg. At the end of four weeks, the dosages of both drugs were doubled. The primary efficacy endpoint was reduction in diastolic blood pressure at the drugs' lowest blood levels for the day (24 hours +/- three hours). At the end of eight weeks, comparable (p>0.05) blood pressure control was seen with the two drugs, with candesartan and amlodipine lowering blood pressure by a mean 15.2/10.2 mmHg and 15.4/11.3 mmHg, respectively. Overall, blood pressure was controlled in 79 percent of the candesartan patients and 87 percent of the amlodipine patients. In CASTLE, 3.3 percent of the candesartan patients discontinued participation versus 9.4 percent of the amlodipine patients. Peripheral edema, the primary pre-specified tolerability endpoint (fluid accumulation marked by skin staying pitted if gently pressed for five seconds) was significantly more common (p<0.005) in the amlodipine patients (22.1 percent) versus the candesartan patients (8.9 percent), with more patients rated moderate or severe with the former drug than the latter. "Studies like this are useful for the practicing doctor because they highlight what a doctor should expect to see when using a drug," said Myron H. Weinberger, M.D., professor of medicine, Indiana University School of Medicine and a CASTLE Study investigator. "If our patients can achieve effective blood pressure control with a lower incidence of side effects such as the foot and ankle swelling observed in this study with amlodipine, it's important for us to know," continued Dr. Weinberger. Angiotensin II receptor blockers represent the first new class of antihypertensive agents in the United States in more than a decade. ARBs work by inhibiting the effects of angiotensin II, a peptide that constricts blood vessels and leads to hypertension. The class is gaining rapid acceptance among physicians and patients due to the absence of many unwanted side effects found in some older antihypertensive medications. Atacand is indicated for once-daily treatment of hypertension. It may be used alone or in combination with other antihypertensive medications. As with other drugs that act directly on the renin-angiotensin system, Atacand should not be used by pregnant women and should be discontinued if pregnancy is detected. AstraZeneca is a major international healthcare business engaged in the research, development, manufacture and marketing of ethical (prescription) pharmaceuticals and the supply of healthcare services. It is one of the top five pharmaceutical companies in the world with healthcare sales of $15 billion and leading positions in cardiovascular, gastrointestinal, oncology, anesthesia including pain management, central nervous system (CNS) and respiratory products. In the United States, AstraZeneca is a $7.4 billion healthcare business with approximately 9,500 employees. Related links: Atacand, Norvasc and .
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