Key result
Long-term therapy with olmesartan, azilsartan, and telmisartan significantly reduced large artery stiffness by 5-7% from baseline according to CAVI, with no significant difference between the groups.
Why the study?
The Cardio-Ankle Vascular Index assesses large artery stiffness independent of blood pressure, but the comparative effects of different ARBs on CAVI over 12 months needed evaluation.
Does long-term therapy with different ARBs (olmesartan, azilsartan, telmisartan) reduce large artery stiffness in patients with mild to moderate hypertension?
RCT (n=126)
Open-label
Envelope method
No
Does long-term therapy with different ARBs (olmesartan, azilsartan, telmisartan) reduce large artery stiffness in patients with mild to moderate hypertension?
Long-term therapy with olmesartan, azilsartan, or telmisartan equally reduces large artery stiffness (CAVI) by 5-7% and effectively lowers blood pressure in patients with mild to moderate hypertension.
Clinicians may select among these ARBs by cost or tolerability; confirms equivalent vascular effects on arterial stiffness.
In recent years, the method of determining the Cardio-Ankle Vascular Index (CAVI) has been introduced into clinical practice, which can be used to determine changes in the stiffness of the large arteries regardless of changes in blood pressure (BP). Aim. To compare the effect of 12-month angiotensin II receptor blocker (ARB) therapy with olmesartan, azilsartan and telmisartan on the large arteries stiffness based on the CAVI determination. Material and methods. The study included 126 patients (57 men, 69 women) with hypertension, who were selected to compare the effect of ARB drug therapy on the arterial stiffness by CAVI: olmesartan, azilsartan and telmisartan for 12 months. All patients had mild and moderate hypertension. The patients underwent the following examinations: office BP measurement, ambulatory BP monitoring (ABPM), biochemical blood test, echocardiogram, CAVI, registration of side effects. Results. The average office systolic BP (SBP) throughout the group was 152.56 ± 1.00 mm Hg, office diastolic BP (DBP) – 94.83 ± 0.58 mm Hg, heart rate (HR) – 72.46 ± 0.80 bpm, 24-hour SBP – 135.60 ± 0.96 mm Hg, 24-hour DBP – 82.41 ± 0.84 mm Hg, 24-hour HR – 71.88 ± 0.89 beats/min., CAVI on the right – 7.89 ± 0.27, CAVI on the left – 8.00 ± 0.31. Office and ambulatory BP indicators were decreased equally in all groups. In the olmesartan group, CAVI was significantly decreased by 7 % on the right (P < 0.05) and 5 % on the left (P < 0.05). In the telmisartan group, CAVI was decreased by 6 % on the right (P < 0.05) and 5 % on the left (P < 0.05). In the azilsartan group, CAVI was significantly decreased by 5 % both on the right (P < 0.05) and left (P < 0.05). Conclusions. Long-term antihypertensive therapy with three different AT II receptor blockers, olmesartan, azilsartan, and telmisartan has helped to reduce stiffness of the large arteries according to CAVI by 5–7 % from the initial level.
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Rekovets et al. (2022) conducted an RCT in Mild to moderate essential hypertension (n=126). Angiotensin II receptor blockers (olmesartan, azilsartan, telmisartan) vs. Active comparators (head-to-head) was evaluated on Change in Cardio-Ankle Vascular Index (CAVI) after 12 months (5-7% reduction from baseline, p=<0.05). Long-term therapy with olmesartan, azilsartan, and telmisartan significantly reduced large artery stiffness by 5-7% from baseline according to CAVI, with no significant difference between the groups.
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