Key result
Switching to azilsartan significantly reduced office systolic blood pressure from 149 mm Hg to 132 mm Hg in hypertensive patients responding poorly to other ARBs.
Why the study?
Does switching to azilsartan improve blood pressure control in hypertensive patients responding poorly to other ARBs?
Observational (n=265)
Open-label
Yes
Does switching to azilsartan improve blood pressure control in hypertensive patients responding poorly to other ARBs?
Absolute Event Rate: 132% vs 149%
p-value: p=<0.001
Switching to azilsartan significantly reduced office and home blood pressure in hypertensive patients who had poor control on other ARBs.
May support azilsartan switch in ARB nonresponders; hypothesis-generating, needs randomized confirmation.
BACKGROUND: Azilsartan is an angiotensin II receptor blocker with a potent antihypertensive effect. METHODS: In a multicenter, prospective, open-label study, 265 patients with poor blood pressure control despite treatment with other angiotensin II receptor blockers were switched to 20 mg/day of azilsartan (patients on standard dosages) or 40 mg/day of azilsartan (patients on high dosages). RESULTS: Blood pressure was 149/83 mm Hg before switching and was significantly reduced from 1 month after switching until final assessment (132/76 mm Hg, P < 0.001). The pulse rate was 72/min before switching and increased significantly from 3 months after switching until final assessment (74/min, P < 0.005). A significant decrease of home morning systolic and diastolic pressure was observed from 1 and 3 months, respectively. Home morning blood pressure was 143/82 mm Hg before switching and 130/76 mm Hg at final assessment (P < 0.01). The morning-evening difference of systolic blood pressure decreased from 14.6 to 6.6 mm Hg after switching (P = 0.09). The estimated glomerular filtration rate was significantly decreased at 3, 6, and 12 months after switching, and serum uric acid was significantly increased at 12 months. No serious adverse events occurred. CONCLUSION: Azilsartan significantly reduced the blood pressure and decreased diurnal variation in patients responding poorly to other angiotensin II receptor blockers.
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Okamura et al. (2018) conducted an observational in Essential hypertension (n=265). Azilsartan vs. Baseline (other ARBs) was evaluated on Office systolic blood pressure at final assessment (p=<0.001). Switching to azilsartan significantly reduced office systolic blood pressure from 149 mm Hg to 132 mm Hg in hypertensive patients responding poorly to other ARBs.
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