Antihypertensive Effect of Azilsartan Versus Olmesartan in Patients with Essential Hypertension: a Meta-analysis

Overview

Journal Ir J Med Sci

Specialty General Medicine

Date 2018 Jul 5

PMID 29971568

Citations 4

Authors

Di Zhao

Hui Liu

Pingshuan Dong

Affiliations

Soon will be listed here.

Abstract

Objective: The comparison of antihypertensive effects between azilsartan and olmesartan in patients with essential hypertension has been investigated in several studies. The results were not consistent. We performed this meta-analysis determining the antihypertensive effect of azilsartan versus olmesartan in patients with essential hypertension.

Methods: Pubmed, Web of Science, and Cochrane Central were searched for all published randomized studies comparing the antihypertensive effects between azilsartan and olmesartan in patients with essential hypertension.

Results: The antihypertensive effects were assessed in 1402 patients included in five trials. The reduction of office systolic blood pressure treated with azilsartan was greater than olmesartan (weighted mean differences (WMD) - 2.15 (95% confidence interval (CI), - 3.78, - 0.53) mm Hg, p < 0.01). There was no significant difference in reduction of office diastolic blood pressure between azilsartan and olmesartan (WMD - 0.99 (95% CI, - 2.06, 0.08) mm Hg, p > 0.05). The reduction of office systolic blood pressure treated with azilsartan was greater than olmesartan at same dose for both drugs (WMD - 2.24 (95% CI, - 4.03, - 0.44) mm Hg, p < 0.05), whereas there was no significant difference in reduction of office diastolic blood pressure between azilsartan and olmesartan (WMD - 0.55 (95% CI, - 1.76, 0.66) mm Hg, p > 0.05).

Conclusions: This meta-analysis provides the evidence that the reduction of office systolic blood pressure treated with azilsartan was greater than olmesartan in patients with essential hypertension. These findings suggest the importance of strict designed randomized controlled trials in determining antihypertensive effects of angiotensin II receptor blockers in clinical practice.

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References

Higgins J, Thompson S, Deeks J, Altman D . Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414):557-60. PMC: 192859. DOI: 10.1136/bmj.327.7414.557. View

Nishimura T, Hashimoto J, Ohkubo T, Kikuya M, Metoki H, Asayama K . Efficacy and duration of action of the four selective angiotensin II subtype 1 receptor blockers, losartan, candesartan, valsartan and telmisartan, in patients with essential hypertension determined by home blood pressure measurements. Clin Exp Hypertens. 2005; 27(6):477-89. DOI: 10.1081/CEH-200067668. View

Bakris G, Sica D, Weber M, White W, Roberts A, Perez A . The comparative effects of azilsartan medoxomil and olmesartan on ambulatory and clinic blood pressure. J Clin Hypertens (Greenwich). 2011; 13(2):81-8. PMC: 8673073. DOI: 10.1111/j.1751-7176.2010.00425.x. View

White W, Weber M, Sica D, Bakris G, Perez A, Cao C . Effects of the angiotensin receptor blocker azilsartan medoxomil versus olmesartan and valsartan on ambulatory and clinic blood pressure in patients with stages 1 and 2 hypertension. Hypertension. 2011; 57(3):413-20. DOI: 10.1161/HYPERTENSIONAHA.110.163402. View

Sica D, White W, Weber M, Bakris G, Perez A, Cao C . Comparison of the novel angiotensin II receptor blocker azilsartan medoxomil vs valsartan by ambulatory blood pressure monitoring. J Clin Hypertens (Greenwich). 2011; 13(7):467-72. PMC: 8108745. DOI: 10.1111/j.1751-7176.2011.00482.x. View

Baker W, White W . Azilsartan medoxomil: a new angiotensin II receptor antagonist for treatment of hypertension. Ann Pharmacother. 2011; 45(12):1506-15. DOI: 10.1345/aph.1Q468. View

Hasegawa H, Takano H, Kameda Y, Kubota A, Kobayashi Y, Komuro I . Effect of switching from telmisartan, valsartan, olmesartan, or losartan to candesartan on morning hypertension. Clin Exp Hypertens. 2012; 34(2):86-91. DOI: 10.3109/10641963.2011.628729. View

Rakugi H, Enya K, Sugiura K, Ikeda Y . Comparison of the efficacy and safety of azilsartan with that of candesartan cilexetil in Japanese patients with grade I-II essential hypertension: a randomized, double-blind clinical study. Hypertens Res. 2012; 35(5):552-8. PMC: 3348575. DOI: 10.1038/hr.2012.8. View

Kurtz T, Kajiya T . Differential pharmacology and benefit/risk of azilsartan compared to other sartans. Vasc Health Risk Manag. 2012; 8:133-43. PMC: 3295635. DOI: 10.2147/VHRM.S22595. View

10.

Imaizumi S, Miura S, Yahiro E, Uehara Y, Komuro I, Saku K . Class- and molecule-specific differential effects of angiotensin II type 1 receptor blockers. Curr Pharm Des. 2012; 19(17):3002-8. DOI: 10.2174/1381612811319170005. View

11.

Akyurek O, Akbal E, Gunes F, Akyurek N . Peroxisome proliferator-activated receptor gamma concentrations in newly diagnosed hypertension patients and the metabolic effects of olmesartan. Arch Med Res. 2014; 45(2):138-42. DOI: 10.1016/j.arcmed.2013.12.005. View

12.

Iwanami J, Mogi M, Tsukuda K, Wang X, Nakaoka H, Ohshima K . Role of angiotensin-converting enzyme 2/angiotensin-(1-7)/Mas axis in the hypotensive effect of azilsartan. Hypertens Res. 2014; 37(7):616-20. DOI: 10.1038/hr.2014.49. View

13.

Furuhashi M, Moniwa N, Mita T, Fuseya T, Ishimura S, Ohno K . Urinary angiotensin-converting enzyme 2 in hypertensive patients may be increased by olmesartan, an angiotensin II receptor blocker. Am J Hypertens. 2014; 28(1):15-21. DOI: 10.1093/ajh/hpu086. View

14.

Abe M, Oikawa O, Okada K, Soma M . Urinary angiotensin-converting enzyme 2 increases in diabetic nephropathy by angiotensin II type 1 receptor blocker olmesartan. J Renin Angiotensin Aldosterone Syst. 2014; 16(1):159-64. DOI: 10.1177/1470320314551443. View

15.

Raff U, Walker S, Ott C, Schneider M, Schmieder R . Olmesartan improves pulse wave velocity and lowers central systolic blood pressure and ambulatory blood pressure in patients with metabolic syndrome. J Clin Hypertens (Greenwich). 2014; 17(2):98-104. PMC: 8032153. DOI: 10.1111/jch.12458. View

16.

Ravarotto V, Pagnin E, Maiolino G, Fragasso A, Carraro G, Rossi B . The blocking of angiotensin II type 1 receptor and RhoA/Rho kinase activity in hypertensive patients: Effect of olmesartan medoxomil and implication with cardiovascular-renal remodeling. J Renin Angiotensin Aldosterone Syst. 2015; 16(4):1245-50. DOI: 10.1177/1470320315594324. View

17.

Harrell R, Karim A, Zhang W, Dudkowski C . Effects of Age, Sex, and Race on the Safety and Pharmacokinetics of Single and Multiple Doses of Azilsartan Medoxomil in Healthy Subjects. Clin Pharmacokinet. 2015; 55(5):595-604. PMC: 4823318. DOI: 10.1007/s40262-015-0333-8. View

18.

Kario K, Saito I, Kushiro T, Teramukai S, Yaginuma M, Mori Y . Persistent olmesartan-based blood pressure-lowering effects on morning hypertension in Asians: the HONEST study. Hypertens Res. 2016; 39(5):334-41. PMC: 4865473. DOI: 10.1038/hr.2015.148. View

19.

White W, Cuadra R, Lloyd E, Bakris G, Kupfer S . Effects of azilsartan medoxomil compared with olmesartan and valsartan on ambulatory and clinic blood pressure in patients with type 2 diabetes and prediabetes. J Hypertens. 2016; 34(4):788-97. PMC: 4947533. DOI: 10.1097/HJH.0000000000000839. View

20.

Handley A, Lloyd E, Roberts A, Barger B . Safety and tolerability of azilsartan medoxomil in subjects with essential hypertension: a one-year, phase 3, open-label study. Clin Exp Hypertens. 2016; 38(2):180-8. PMC: 4819839. DOI: 10.3109/10641963.2015.1081213. View