Key result
Switching to azilsartan is linked to an ~18 mmHg drop in systolic BP in hemodialysis.
Why the study?
Azilsartan is a new angiotensin receptor blocker with more continuous antihypertensive effects, and its efficacy and safety in hemodialysis patients with uncontrolled hypertension needed demonstration.
Does azilsartan improve efficacy and safety compared to olmesartan in hemodialysis patients with uncontrolled hypertension?
Observational (n=22)
Does azilsartan improve efficacy and safety compared to olmesartan in hemodialysis patients with uncontrolled hypertension?
Azilsartan may be more effective than olmesartan for managing uncontrolled hypertension in hemodialysis patients.
Answers are grounded in this paper and cite their sources.
Azilsartan switch linked to home SBP drop in hemodialysis hypertension; hypothesis-generating, requires RCTs before any practice change.
Background: Azilsartan is a new angiotensin receptor blocker with more continuous antihypertensive effects.The objective of this study was to demonstrate the efficacy and safety of azilsartan in hemodialysis patients with uncontrolled hypertension.Methods: Twenty-two hemodialysis patients treated with multiple antihypertensive drugs including olmesartan (20-40 mg/day) were enrolled in this retrospective observational study.Blood pressure was measured in the morning and evening for a week at baseline and after switching from olmesartan to azilsartan.The patients' mean blood pressure at baseline was 171/71 mmHg.Olmesartan (20-40 mg/day) was switched to azilsartan with the same dose.An electrocardiogram, an echocardiogram, and measurement of the ankle-brachial index were performed in all patients, and the echocardiogram showed left ventricular hypertrophy in all patients.Home-measured blood pressure, heart rate, and serum potassium were followed for 9 months after switching.Results: Systolic blood pressure was significantly decreased at 1, 3, 6, and 9 months after switching.Diastolic blood pressure was significantly decreased at 3 and 6 months after switching.Switching did not alter the serum potassium level.Conclusions: Switching from olmesartan to azilsartan significantly and safely decreased home-measured blood pressure in hemodialysis patients.
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Akira Matsuda (2014) conducted an observational in Uncontrolled hypertension in hemodialysis patients (n=22). Azilsartan vs. Olmesartan (baseline) was evaluated on Mean systolic blood pressure at 9 months (p=<0.001). Switching from olmesartan to azilsartan significantly decreased mean home-measured systolic blood pressure from 170.7 mmHg at baseline to 153.0 mmHg at 9 months in hemodialysis patients.
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