Effects of olmesartan medoxomil on systolic blood pressure and pulse pressure in the management of hypertension

BACKGROUND: In this analysis, we evaluated the efficacy of the angiotensin II receptor blocker olmesartan medoxomil in reducing systolic blood pressure (SBP) and pulse pressure (PP) in hypertensive patients. METHODS: Data from seven randomized, double blind, placebo controlled, 6- to 12-week efficacy trials of olmesartan 20 mg and 40 mg/day were analyzed to determine changes in trough seated SBP and PP within three cohorts: 1) total cohort (n = 1777); 2) subjects with a wide PP: that is, those with a baseline PP >55 mm Hg (n = 917); and 3) a subpopulation of patients with a wide PP and age > or = 65 years (n = 296). Statistical comparisons used least squares mean values. RESULTS: In the total cohort, olmesartan 20 and 40 mg/day resulted in mean reductions in SBP of 15.1 and 17.6 mm Hg, respectively (P or = 65 years, olmesartan 20 and 40 mg/day produced mean reductions in SBP of 21.8 and 22.5 mm Hg, and PP of 6.7 and 7.6 mm Hg, respectively (P or = 65 years, the population at greatest risk for cardiovascular morbidity and mortality, olmesartan reduces PP to an extent similar to that in patients <65 years of age.