Olmesartan medoxomil 80 mg daily blocked the 24-hour systolic blood pressure response to angiotensin I by 76%, proving as effective as combining lower doses with lisinopril.
RCT (n=30)
Double-blind
Randomized
No
Does a high dose of olmesartan medoxomil (80 mg) provide as much 24-hour blockade of the renin-angiotensin system as the combination of lisinopril and a lower dose of olmesartan in healthy normotensive subjects?
A high dose of a long-acting ARB (olmesartan 80 mg) provides equivalent 24-hour blockade of the renin-angiotensin system compared to combining a lower dose ARB with an ACE inhibitor, offering a simpler regimen without ACE inhibitor side effects.
Tasa de eventos absoluta: 76% vs 83%
valor p: p=0.3
Whether a higher dose of a long-acting angiotensin II receptor blocker (ARB) can provide as much blockade of the renin-angiotensin system over a 24-hour period as the combination of an angiotensin-converting enzyme inhibitor and a lower dose of ARB has not been formally demonstrated so far. In this randomized double-blind study we investigated renin-angiotensin system blockade obtained with 3 doses of olmesartan medoxomil (20, 40, and 80 mg every day) in 30 normal subjects and compared it with that obtained with lisinopril alone (20 mg every day) or combined with olmesartan medoxomil (20 or 40 mg). Each subject received 2 dose regimens for 1 week according to a crossover design with a 1-week washout period between doses. The primary endpoint was the degree of blockade of the systolic blood pressure response to angiotensin I 24 hours after the last dose after 1 week of administration. At trough, the systolic blood pressure response to exogenous angiotensin I was 58% +/- 19% with 20 mg lisinopril (mean +/- SD), 58% +/- 11% with 20 mg olmesartan medoxomil, 62% +/- 16% with 40 mg olmesartan medoxomil, and 76% +/- 12% with the highest dose of olmesartan medoxomil (80 mg) (P = .016 versus 20 mg lisinopril and P = .0015 versus 20 mg olmesartan medoxomil). With the combinations, blockade was 80% +/- 22% with 20 mg lisinopril plus 20 mg olmesartan medoxomil and 83% +/- 9% with 20 mg lisinopril plus 40 mg olmesartan medoxomil (P = .3 versus 80 mg olmesartan medoxomil alone). These data demonstrate that a higher dose of the long-acting ARB olmesartan medoxomil can produce an almost complete 24-hour blockade of the blood pressure response to exogenous angiotensin in normal subjects. Hence, a higher dose of a long-acting ARB is as effective as a lower dose of the same compound combined with an angiotensin-converting enzyme inhibitor in terms of blockade of the vascular effects of angiotensin.
Hasler et al. (Tue,) conducted a rct in Healthy normotensive subjects (n=30). Olmesartan medoxomil vs. Lisinopril 20 mg plus olmesartan medoxomil 40 mg was evaluated on Degree of blockade of the systolic blood pressure response to exogenous angiotensin I 24 hours after the last dose (p=0.3). Olmesartan medoxomil 80 mg daily blocked the 24-hour systolic blood pressure response to angiotensin I by 76%, proving as effective as combining lower doses with lisinopril.