MPS 14-03 Effects of Azilsartan medoxomil compared to other angiotensin II receptor blocker on plasma aldosterone levels in patients with essential hypertension. (September 2016)

• Record Type: Journal Article
• Authors: Okamoto, Shinya; Iwasaki, Hitoshi; Dohi, Kaoru; Okamoto, Ryuuji; Fujii, Eitarou; Yamada, Norikazu; Itou, Masaaki
• Is Part Of: Journal of hypertension. Volume 34:(2016) Supplement 1
• Publication Date: 2016-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000501058.20546.2d
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Background: Chronic treatment with angiotensin II receptor blocker (ARB) may often cause diminished efficacy of treatment, so-called "aldosterone breakthrough in patients with essential hypertension. Aim: We examined the effects of Azilsartan medoxomil (AZM) on blood pressure (BP) control and plasma aldosterone concentration (PAC) by switching from other ARBs. Design and Method: We enrolled 14 patients with essential hypertension in whom BP control was insufficient with chronic ARB treatment (Candesartan 8 mg or Telmisartan 40 mg or Olmesartan 20 mg: mean duration 6.4years) other than AZM (20 mg). All patients underwent measurement of morning PAC at baseline, 12 months and 24 months after switching to AZM, in the morning after 30 min of rest in a supine position after 30 minutes of supine position. Results: Both home and office BP decreased during the time course after switching to AZM (Home BP: 140.4 ± 21.5 / 75.8 ± 14.7 mmHg at baseline, 130.3 ± 10.4 / 67.8 ± 7.5* mmHg at 12 months and 133.4 ± 21.3 / 71.3 ± 8.8*† mmHg at 24 months. Office BP: 144.4 ± 16.1 / 83.3 ± 12.1 mmHg at baseline, 132.9 ± 15.1 / 72.5 ± 11.5* mmHg at 12 months and 124.8 ± 6.3 / 68.8 ± 5.2*† mmHg at 24 months, *p < 0.05 vs. baseline and †p < 0.05 vs. 12 months). In contrast, PAC remained unchanged after switching to AZM (10.1 ± 2.8 ng/dl at baseline, 9.9 ± 3.1 ng/dl at 12 months and 9.7 ± 2.6 ng/dl at 24 months). Conclusions: AZM had greater BP lowering effects than other ARBs, with no different impacts on PAC throughout the 24-month treatment. Figure. No caption available.