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Hypertension accounts for number of morbidities and mortalities in Syria. We know that each specific population has its own particulars and might have different responses to drugs due to pharmacokinetics and pharmacodynamics. In Syria, there are many national pharmaceutical companies which produce multiple antihypertensive drugs.
In order to comply with Evidence Based Medicine, we studied two antihypertensive drugs produced by these companies. Two large Post Marketing Surveillance studies were carried out and they were the pioneer efforts in Syria. They looked at efficacy, safety and tolerability of Rennin Angiotensin Aldosterone System suppressing drugs.
The first study VHEST (Valsartan® in Hypertension, Efficacy, Safety and Tolerability) and the second study REST (Revosyl® Efficacy, Safety and Tolerability) while Revosyl® is the market name for Perindopril.
These studies were done by a protocol put by an experienced hypertensive specialist and carried out by number of physicians in different geographic locations in Syria. These studies were open label, controlled, observational, prospective, post marketing, non interventional clinical studies.
VHEST included 1500 essential hypertension patients (grade I, II and Isolated systolic hypertension) with a follow up of 12 weeks. Investigators were 100 physicians (Cardiologists, Endocrinologists, Neurologists, Internists and Nephrologists). Conclusion was that Valsartan® ± HCTZ is efficacious, well tolerated and safe. The most reported side effects were headache& dizziness.
REST included 2250 patients with Essential Hypertension (Grade I, II& Isolated Systolic Hypertension). Follow up was 12 weeks and 141 physicians participated. It showed that Perindopril is efficacious with an acceptable level of systolic and diastolic blood pressure reduction and a good control and response rates. The concomitant presences of CHF or renal disease were associated with intense reduction of DBP while patients with concomitant cerebrovascular accidents or left ventricular hypertrophy showed a tendency to reduce SBP easier. The most frequently reported side effects were cough& headache.
In conclusion, antihypertensive drugs produced by national pharmaceutical companies are reasonable choice for treating patients with hypertension.