Comparison of Effects of Azelnidipine and Trichlormethiazide in Combination with Olmesartan on Blood Pressure and Metabolic Parameters in Hypertensive Type 2 Diabetic Patients

Overview

Journal J Diabetes Investig

Specialty Endocrinology

Date 2014 May 21

PMID 24843534

Citations 2

Authors

Hidenori Yoshii

Tomoya Mita

Junko Sato

Yuuki Kodama

Jong Bock Choi

Koji Komiya

Kazuhisa Matsumoto

Rei Kanno

Masahiko Kawasumi

Hajime Koyano

Takahisa Hirose

Tomio Onuma

Ryuzo Kawamori

Hirotaka Watada

Affiliations

Soon will be listed here.

Abstract

Unlabelled: Aims/Introduction: Angiotensin II type 1 receptor blockers (ARB) are regarded as first-line treatment for type 2 diabetes with hypertension. However, lowering blood pressure to the target level often requires more than one antihypertensive agent as recommended by the guideline. In this open-label, prospective, crossover clinical trial, we compared the effects of combination treatment of ARB with a calcium channel blocker (CCB) or with a low-dose thiazide diuretic on blood pressure (BP) and various metabolic parameters in hypertensive patients with type 2 diabetes.

Materials And Methods: A total of 39 Japanese type 2 diabetics with hypertension treated with olmesartan (20 mg/day) for at least 8 weeks were recruited to this study. At study entry, treatment was switched to either olmesartan (20 mg/day)/azelnidipine (16 mg/day) or olmesartan (20 mg/day)/trichlormethiazide (1 mg/day) and continued for 12 weeks. Then, the drugs were switched and treatment was continued for another 12 weeks. We measured clinical blood pressure and various metabolic parameters before and at the end of each study arm.

Results: Compared with the olmesartan/trichlormethiazide treatment, treatment with olmesartan/azelnidipine achieved superior clinical blood pressure and pulse rate control. In contrast, the treatment with olmesartan/trichlormethiazide resulted in increased HbA1c, serum uric acid and worsening of estimated glomerular filtration rate, though there were no differences in other metabolic parameters including urine 8-hydroxy-2'-deoxyguanosine, C-reactive protein and adiponectin between the two treatments.

Conclusions: Our results show that the combination of ARB with azelnidipine is more beneficial with regard to blood pressure control and metabolic outcome than the combination of olmesartan with low dose trichlormethiazide. This trial was registered with UMIN clinical trial registry (no. UMIN000005064). (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00135.x, 2011).

Citing Articles

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Thamcharoen N, Susantitaphong P, Wongrakpanich S, Chongsathidkiet P, Tantrachoti P, Pitukweerakul S Hypertens Res. 2015; 38(12):847-55.

PMID: 26134125 DOI: 10.1038/hr.2015.69.

Comparison of effects of pitavastatin and atorvastatin on glucose metabolism in type 2 diabetic patients with hypercholesterolemia.

Mita T, Nakayama S, Abe H, Gosho M, Iida H, Hirose T J Diabetes Investig. 2014; 4(3):297-303.

PMID: 24843669 PMC: 4015667. DOI: 10.1111/jdi.12032.

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