Key result
Azilsartan 20 mg provided a significantly greater blood pressure-lowering effect (15.3 mmHg) compared to valsartan 80 mg (7.9 mmHg) or irbesartan 100 mg (8.2 mmHg) (P≤0.03).
Why the study?
Does the choice of angiotensin II receptor blocker affect the magnitude and velocity of blood pressure reduction in newly diagnosed hypertensive patients?
Cohort (n=232)
Does the choice of angiotensin II receptor blocker affect the magnitude and velocity of blood pressure reduction in newly diagnosed hypertensive patients?
Different ARBs at mid-level doses exhibit significant variations in both the magnitude and speed of blood pressure reduction, suggesting the need for individualized selection.
BACKGROUND: We aimed to examine the blood pressure (BP)-lowering effect and the time to attain the maximal antihypertensive effect (stabilization time) of several angiotensin II receptor blockers (ARBs) based on home BP measurements. METHODS: We surveyed consecutive newly diagnosed, untreated patients with hypertension who started the treatment with a mid-level dose of one of seven ARBs (losartan 50 mg, telmisartan 40 mg, candesartan 8 mg, olmesartan 20 mg, valsartan 80 mg, irbesartan 100 mg, or azilsartan 20 mg). All study participants measured home BP in the morning for at least 1 week during an untreated period and 4 weeks during the treatment period. RESULTS: Age, the proportion of men, and baseline home BP levels did not differ significantly between groups (total n = 232; age, 62.2 years; 50.9% men; home SBP/DBP, 151.6/90.0 mmHg). Significant differences in the BP-lowering effect and the stabilization time between ARBs were observed (P ≤ 0.02). The extent of BP-lowering effects of azilsartan 20 mg was significantly greater than that of valsartan 80 mg or irbesartan 100 mg (15.3 vs. 7.9 or 8.2 mmHg, respectively P ≤ 0.03). The stabilization time of losartan for home SBP was significantly longer than that of valsartan, irbesartan, or azilsartan (22.8 vs. 7.1, 4.7, or 7.1 days, respectively, P ≤ 0.01). CONCLUSION: The maximum effect and the stabilization time differed among ARBs used at the mid-level dose in Japan. An ARB should be chosen based on its desired characteristics.
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Satoh et al. (2016) conducted a cohort in Hypertension (n=232). Azilsartan vs. Valsartan 80 mg or Irbesartan 100 mg was evaluated on Blood pressure-lowering effect (p=≤0.03). Azilsartan 20 mg provided a significantly greater blood pressure-lowering effect (15.3 mmHg) compared to valsartan 80 mg (7.9 mmHg) or irbesartan 100 mg (8.2 mmHg) (P≤0.03).
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