Key result
Switching from candesartan to olmesartan significantly decreased left ventricular mass index from 159.5 to 128.5 g/m2 and reduced angiotensin II and aldosterone levels over one year.
Why the study?
Does switching from candesartan to olmesartan improve the renin-angiotensin-aldosterone system and left ventricular mass index in patients with essential hypertension after cardiac surgery?
Does switching from candesartan to olmesartan improve the renin-angiotensin-aldosterone system and left ventricular mass index in patients with essential hypertension after cardiac surgery?
Absolute Event Rate: 128.5% vs 159.5%
p-value: p=<0.0001
Switching from candesartan to olmesartan in post-cardiac surgery patients with essential hypertension significantly reduced angiotensin II, aldosterone, and left ventricular mass index over one year.
May reduce LV mass index post-cardiac surgery; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Various angiotensin II receptor blockers are widely used for the treatment of hypertension in recent years. The results of large-scale clinical studies have shown that they have various efficacies: not only hypotensive effects but also organ protective effects. In this study, the effects of a change-over from candesartan to olmesartan on renin-angiotensin-aldsterone system, cardiomegaly and peripheral circulation were studied. METHODS: Participants enrolled in this trial were outpatients with essential hypertension after cardiac surgery who had received candesartan for more than one year. Fifty-six patients switched from candesartan to olmesartan. The primary endpoints were 1) renin activity, angiotensin II, aldosterone, and 2) left ventricular mass index (LVMI). RESULTS: It was clear that angiotensin II and aldosterone are decreased by the potent hypotensive effects of olmesartan in a change-over from candesartan to olmesartan. Since LVMI and BNP were decreased, inhibitory effects on myocardial hypertrophy were also confirmed. CONCLUSION: In the present study, left ventricular hypertrophy and on arterial compliance were inhibited by a decrease in angiotensin II and aldosterone due to the change-over to olmesartan. In the future, protective effects on organs will be clarified by long-term observations.
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Sezai et al. (2011) studied Essential hypertension after cardiac surgery (n=56). Olmesartan vs. Baseline (candesartan 4 mg/day or 8 mg/day) was evaluated on Left ventricular mass index (LVMI) at 1 year (p=<0.0001). Switching from candesartan to olmesartan significantly decreased left ventricular mass index from 159.5 to 128.5 g/m2 and reduced angiotensin II and aldosterone levels over one year.
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