What is the estimated mean change in SBP for an average patient taking 2000 mg of Bosentan? Provide a 95% confidence interval corresponding to this estimate.

Hypertension

Endothelin is a powerful vasoconstrictor peptide derived from the endothelium. The contribution of endothelin to blood pressure regulation in patients with hypertension was assessed by studying the effect of an endothelin-receptor antagonist, Bosentan. In the study, 293 patients with mild to moderate hypertension were randomized to receive one of four oral doses of Bosentan (100, 500, 1000, or 2000 mg daily), a placebo, or the ACE (angiotensin-converting enzyme) inhibitor enalapril (an established antihypertensive drug) [18]. The reported mean changes in systolic blood pressure (SBP) over a 24-hour period are shown in Table 11.23.

Table 11.23: Mean change in SBP over 24 hours

 

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Mean Bosentan In(dose) dose (mg) Group change Placebo -0.9 100 mg bosentan 500 mg bosentan 1000 mg bosentan 2000 mg bosentan -2.5 100 4.61 -8.4 500 6.21 -7.4 1000 6.91 -10.3 2000 7.60