Chinese Herbal Formula Equals Losartan For Treatment of Mild Hypertension

Previous studies demonstrated that the Songling Xuemaikang capsule (SXC) was effective for essential hypertension. However, the efficacy of SXC monotherapy for hypertension remains unclear. Therefore, Dr Ying Gao and her team conducted a study to compare the blood pressure (BP)–lowering efficacy and safety of SXC versus losartan in patients with essential hypertension.

The researchers conducted a multicenter, randomized, double-blind, noninferiority in which 628 patients with mild essential hypertension were randomly assigned to receive either SXC (n=314) or losartan (n=314) for 8 weeks. The major outcome assessed was the change in sitting diastolic BP from baseline to 8 weeks, with a predefined noninferiority margin of −2.5 mm Hg.

Key findings of the study:

• In a primary analysis based on the intention-to-treat principle, the researchers found that the change in diastolic BP from baseline to 8 weeks was similar between the SXC and losartan groups (−7.9 [8.0] versus −8.1 [7.9]).
• They observed that the lower boundary of 95% CI was above the margin of −2.5 mm Hg, showing noninferiority.
• They noted that the results were consistent with per-protocol analysis.
• They observed that the SXC produced greater improvements in total hypertension symptom score (−5.7 [4.2] versus −5.0 [4.0]) and total cholesterol (−0.1 [1.0] versus 0.1 [1.2]).
• They found no differences between groups in the other BP and patient-reported outcomes.
• They noted that the incidence and severity of adverse events were similar between groups.

The authors concluded, "SXC was well tolerated and demonstrated non-inferior to losartan in BP lowering in patients with mild hypertension. SXC might be an alternative for mild hypertension, particularly for patients with a preference for natural medicine."

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DOI: https://doi.org/10.1161/CIRCOUTCOMES.121.007923