Antihypertensive and metabolic effects of high-dose olmesartan and telmisartan in type 2 diabetes patients with hypertension

Arao, Tadashi; Okada, Yosuke; Mori, Hiroko; Nishida, Keiko; Tanaka, Yoshiya

doi:10.1507/endocrj.ej12-0326

Cited by 19 publications

(12 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These finding were similar to previous studies, which found no significant changes in similar metabolic parameters among hypertensive, diabetic patients treated with other ARBs, including eprosartan, OLM, and telmisartan [ 18 , 21 – 23 ].…”

Section: Discussionsupporting

confidence: 92%

Effects of azilsartan medoxomil compared with olmesartan and valsartan on ambulatory and clinic blood pressure in patients with type 2 diabetes and prediabetes

White

Cuadra

Lloyd

et al. 2016

Journal of Hypertension

View full text Add to dashboard Cite

Background:Angiotensin receptor blockers (ARBs) are preferred antihypertensive therapies in patients with type 2 diabetes mellitus (T2DM). Azilsartan medoxomil (AZL-M) is a potent ARB for the treatment of stages 1-2 hypertension. We compared the efficacy, safety, and metabolic effects of AZL-M to both valsartan (VAL) and olmesartan (OLM), separately in patients with impaired fasting glucose (prediabetes mellitus) and T2DM.Methods:A pooled analysis of 3821 patients from three separate randomized placebo-controlled trials comparing the effects of AZL-M (40 and 80 mg), OLM (40 mg), VAL (320 mg), and placebo on changes in ambulatory and clinic blood pressure (BP) among patients with hypertension and prediabetes mellitus or T2DM was performed. Two analysis pools were created to facilitate comparisons: Pool A included patients who received placebo, AZL-M or OLM and Pool B included those who received AZL-M or VAL. Within each pool, patients were stratified by glycemic subgroups (normoglycemic, prediabetes mellitus, or T2DM) based on hemoglobin A1c values. Changes from baseline in both 24-h and clinic SBP were the primary efficacy assessments.Results:Baseline 24-h mean SBPs were approximately 145 and 146 mmHg in the prediabetes mellitus and T2DM subgroups, respectively; corresponding clinic SBPs were approximately 158 and 159 mmHg. Baseline hemoglobin A1c values for each subgroup (both pools) were normoglycemic, 5.3%; prediabetes mellitus, 6.0%; and T2DM, 6.9%. Changes from baseline in 24-h or clinic SBP were significantly greater with AZL-M, 80 mg compared with either OLM 40 mg or VAL 320 mg in all subgroups in each pool. Safety and tolerability were similar among the active treatment and placebo subgroups.Conclusion:These analyses indicate that AZL-M, 80 mg/day lowers SBP by a greater magnitude than OLM or VAL at maximally approved doses in patients with prediabetes mellitus and T2DM. These findings have important clinical implications for this high-risk patient group.

show abstract

Section: Discussionsupporting

confidence: 92%

Effects of azilsartan medoxomil compared with olmesartan and valsartan on ambulatory and clinic blood pressure in patients with type 2 diabetes and prediabetes

White

Cuadra

Lloyd

et al. 2016

Journal of Hypertension

View full text Add to dashboard Cite

show abstract

“…25 In the European Trial on Olmesartan and Pravastatin in Inflammation and Atherosclerosis, olmesartan significantly reduced several markers of vascular inflammation, including tumor necrosis factor-α and C-reactive protein in patients with essential hypertension and vascular microinflammation. 12 The C-reactive protein-lowering effect of olmesartan has been confirmed in patients with essential hypertension, 26 in patients with stable angina, 27 and in patients with type II diabetes mellitus. 28 In the present study, we selected patients with hypertension and metabolic syndrome.…”

Section: Discussionmentioning

confidence: 96%

Dose-Dependent Arterial Destiffening and Inward Remodeling After Olmesartan in Hypertensives With Metabolic Syndrome

Laurent

Boutouyrie

2014

Hypertension

View full text Add to dashboard Cite

Whether the reduction in arterial stiffness after antihypertensive treatment is only because of the blood pressure (BP) lowering, which unloads the stiff components of the arterial wall such as collagen, or whether additional BP-independent effects are involved, has been largely debated. [1][2][3][4] An increasing body of evidence, including theoretical aspects of arterial mechanics, 4 long-term observational studies in humans, 5 and a recent meta-analysis of double-blind, randomized, controlled trials, 6 suggests that only part of aortic stiffness could be reduced through the normalization of BP by pharmacological treatment, and further reduction of aortic stiffness would require long-term arterial remodeling, including reduction in collagen density and rearrangement of the wall materials.Blockers of the renin-angiotensin-aldosterone system (RAAS) are privileged antihypertensive drugs for such a BP-independent effect on arterial stiffness, mainly through the reduction of arterial wall fibrosis and remodeling. In long-term controlled studies, the angiotensin-converting enzyme inhibitors (ACEIs) perindopril 7 and trandolapril, 8 the combined neutral endopeptidase/ACEI omapatrilat, 9 the angiotensin receptor blocker (ARB) valsartan, 10 and the aldosterone antagonist spironolactone 11 had the capacity to reverse aortic stiffening independently of changes in BP. However, only 1 dose was tested in these studies.A major argument in favor of a BP-independent reduction in aortic stiffness by a RAAS blocker would come from the demonstration of a dose-dependent reduction in aortic stiffness for a given mean BP (MBP) reduction. To our knowledge, no such pharmacodynamic data are yet available. We hypothesized that high doses of olmesartan medoxomil (OM), through various mechanisms common to RAAS blockers in general and ARBs in particular, and possible additional anti-inflammatory effects reported in subjects with hypertension and microinflammation 12 would gradually lower aortic stiffness for a given MBP reduction. This is of particular interest in patients with metabolic syndrome. Impaired glucose metabolism 13 and the clustering of risk factors known as the metabolic syndrome are associated with stiffening of the larger arteries.14-16 Metabolic syndrome is also associated with vascular inflammation, 17 andAbstact-Whether angiotensin receptor blockers can dose-dependently remodel the arterial wall during long-term treatment has been largely debated. In this phase III, multicenter, randomized, double-blind, parallel-group study, 133 subjects with hypertension and metabolic syndrome were assigned to olmesartan, either 20 mg (n=44), 40 mg (n=42), or 80 mg (n=47) once a day, according to a force titration design during a 1-year period. Office blood pressure, 24-hour blood pressure, aortic stiffness (carotid-femoral pulse wave velocity), and carotid parameters were measured at baseline, 24 weeks, and 52 weeks. Pulse wave velocity significantly decreased (P<0.001) with time in each group, with no significant time-dose inter...

show abstract

“…It has been reported that olmesartan has beneficial effects on glucose metabolism, insulin resistance, and lipid metabolism, 20 and that olmesartan significantly reduced vascular inflammation in patients with essential hypertension. 21 Because the inflammatory state, including endothelial dysfunction and increased oxidative stress, is considered as one of the central pathophysiological aspects of HFpEF, 22 these anti-inflammatory and antimetabolic effects of olmesartan could be beneficial for HFpEF patients.…”

Section: Additive Effects Of Olmesartan On Mortality In Hfref and Hfpmentioning

confidence: 99%

Influence of Left Ventricular Ejection Fraction on the Effects of Supplemental Use of Angiotensin Receptor Blocker Olmesartan in Hypertensive Patients With Heart Failure

Miura

Sakata

Miyata

et al. 2016

Circ J

View full text Add to dashboard Cite

show abstract

Antihypertensive and metabolic effects of high-dose olmesartan and telmisartan in type 2 diabetes patients with hypertension

Cited by 19 publications

References 30 publications

Effects of azilsartan medoxomil compared with olmesartan and valsartan on ambulatory and clinic blood pressure in patients with type 2 diabetes and prediabetes

Effects of azilsartan medoxomil compared with olmesartan and valsartan on ambulatory and clinic blood pressure in patients with type 2 diabetes and prediabetes

Dose-Dependent Arterial Destiffening and Inward Remodeling After Olmesartan in Hypertensives With Metabolic Syndrome

Influence of Left Ventricular Ejection Fraction on the Effects of Supplemental Use of Angiotensin Receptor Blocker Olmesartan in Hypertensive Patients With Heart Failure

Contact Info

Product

Resources

About