Effects of Olmesartan on the Renin-angiotensin-aldosterone System for Patients with Essential Hypertension after Cardiac Surgery—Investigation Using a Candesartan Change-over Study—

Sezai, Akira; Soma, Masayoshi; Hata, Mitsumasa; Yoshitake, Isamu; Unosawa, Satoshi; Wakui, Shinji; Shiono, Motomi

doi:10.5761/atcs.oa.11.01691

Cited by 10 publications

(10 citation statements)

References 18 publications

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“…The patients were followed only for 24 weeks in the present study; therefore, a follow-up period of 1 year will be necessary in future studies investigating whether olmesartan and azilsartan are effective in protecting against aldosterone breakthrough. However, some studies have already reported that olmesartan is unlikely to cause aldosterone breakthrough [20], [21]. …”

Section: Discussionmentioning

confidence: 99%

Effects of Olmesartan and Azilsartan on Albuminuria and the Intrarenal Renin-Angiotensin System

Takami¹,

Okada²,

Saito³

et al. 2018

World Journal of Research and Review

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Pages 07-10 7 www.wjrr.org  Abstract-Purpose: Olmesartan and azilsartan decrease blood pressure more effectively than other angiotensin receptor blockers (ARBs). ARBs additionally decrease the urinary albumin to creatinine ratio (UACR), a urinary albumin marker, and urinary angiotensinogen (u-AGT), an intrarenal renin-angiotensin system activity marker. We examined the effects of these ARBs on blood pressure, UACR, and u-AGT in patients with uncontrolled hypertension.Methods: Patients with uncontrolled hypertension treated with conventional ARBs, excluding olmesartan and azilsartan, for over 8 weeks were enrolled. We randomly switched patients from their prior ARBs to either olmesartan or azilsartan, and followed them for 24 weeks.Results: Systolic blood pressure (SBP), diastolic blood pressure (DBP), and central systolic blood pressure (cSBP) significantly decreased at 24 weeks. UACR and u-AGT also decreased at 24 weeks in both groups. There were no significant differences in SBP, DBP, cSBP, UACR, or u-AGT between the groups. Therefore, we combined both groups for further analyses. After combining, SBP (160.5 ± 16.4 to 139.6 ± 15.6 mm Hg, P < 0.0001), DBP (88.4 ± 13.7 to 80.7 ± 13.2 mm Hg, P = 0.008), cSBP (167.4 ± 20.8 to 146.6 ± 24.6 mm Hg, P < 0.0001), UACR (13.8 to 9.0 mg/g Cre, P = 0.0096), and u-AGT (4.13 to 2.32 µg/g Cre, P = 0.0074) significantly decreased at 24 weeks. Patients with microalbuminuria (UACR ≥ 30 mg/g Cre) had significantly greater ΔUACR (-39.4 vs 0.27, P = 0.0024) and Δu-AGT (-11.9 vs -0.61, P = 0.0235) than patients without microalbuminuria. The changes in u-AGT were significantly associated with changes in UACR (r = 0.411, P = 0.046); however, there was no significant relationship between the changes in u-AGT and those in SBP or DBP.Conclusion: Olmesartan and azilsartan decreased blood pressure, UACR, and u-AGT more than the other ARBs, and exerted depressor and renoprotective effects.Index Terms-blood pressure, urinary albumin, urinary angiotensinogen, angiotensin receptor blockers.

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Section: Discussionmentioning

confidence: 99%

Effects of Olmesartan and Azilsartan on Albuminuria and the Intrarenal Renin-Angiotensin System

Takami¹,

Okada²,

Saito³

et al. 2018

World Journal of Research and Review

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“…As a selective AT 1 R antagonist, olmesartan can inhibit RAS activation, and reduce plasma PRA and Ang II levels as well as the renal vascular sensitivity to catecholamines [1,14]. In contrast to other AT 1 R antagonists, olmesartan has an inverse activating effect when binding to AT 1 R, and thus inactivate AT 1 R and alleviate damage to the kidney induced by Ang II [22,23]. Moreover, the combination of Ang II and AT 2 R plays a role in physiological renal protection [24].…”

Section: Discussionmentioning

confidence: 99%

High-dose nitrate therapy recovers the expression of subtypes α1 and β-adrenoceptors and Ang II receptors of the renal cortex in rats with myocardial infarction-induced heart failures

Yubo

Chen

et al. 2020

BMC Cardiovasc Disord

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Background: Few studies examined the effect of long-acting nitrates on renal function in chronic heart failure (CHF). Thus, we aimed to investigate the effect of long-acting nitrate on the expression of adrenoceptors (AR) and angiotensin II receptor (ATR) subtypes of the renal cortex, in rats with myocardial infarction-induced CHF. Methods: Rats were randomly divided into the following groups: control, sham-operated, CHF, low-and high-dose nitrate, positive drug control (olmesartan), and high-dose of long-acting nitrate + olmesartan. Ultrasound echocardiography markers were compared, and the levels of AR subtypes, AT 1 R, and AT 2 R were measured using reverse transcription-polymerase chain reaction and western blot analysis. Histopathology of the kidney was determined on hematoxylin and eosin-stained sections. Results: CHF significantly increased plasma renin activity (PRA) and angiotensin II levels, upregulated AT 1 R expression and downregulated α 1A-, β 1-, β 2-AR, and AT 2 R expression compared to the sham control. High-dose nitrate or olmesartan alone, and especially in combination, decreased the levels of PRA and angiotensin II and downregulated the CHF-induced expression of AT 1 R, α 1A-, β 1-, and β 2-AR, and AT 2 R. CHF resulted in significant impairment of the renal tissue, including inflammatory cells infiltration to the tubular interstitium and surrounding the renal glomerulus, and tubular necrosis, which was alleviated in all treatment groups to different degrees. Conclusions: Long-acting nitrates could reverse CHF-induced changes in AR and ATR subtypes in the kidney, and improve cardiac function to protect renal function. Compared with monotherapy, the combination of nitrates and olmesartan shows more significant benefits in regulating AR and ATR subtypes.

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“…Regarding the strength and durability of the antihypertensive effect of olmesartan in patients with essential hypertension, Brunner et al5 conducted a double-blind controlled study that compared olmesartan and candesartan on the basis of ambulatory BP, whereas Sezai et al9 assessed the antihypertensive effect of olmesartan on early morning BP, and Furukawa et al10 investigated the efficacy of olmesartan therapy on ambulatory BP monitoring. These studies have revealed the superiority of olmesartan over candesartan with regard to the strength and duration of its antihypertensive effects.…”

Section: Discussionmentioning

confidence: 99%

Difference in the effects of switching from Candesartan to Olmesartan or Telmisartan to Olmesartan in hypertensive patients with type 2 diabetes: the COTO study

Daikuhara¹,

Fukunaga²,

Ohshima³

2014

DDDT

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PurposeThis open-label controlled study compared the therapeutic efficacy of three representative angiotensin II receptor blockers (ARBs) in hypertensive patients with type 2 diabetes attending a hospital outpatient clinic. The primary measure in this study was morning home blood pressure (BP).Patients and methodsTwo studies were done concurrently to investigate the effects of switching from two different ARBs to olmesartan. Patients prescribed candesartan (8 mg once daily in the morning) or telmisartan (40 mg once daily in the morning) for 16 weeks were switched to olmesartan (20 mg once daily in the morning) for 16 weeks. Then, they were switched back to candesartan (CO group) or telmisartan (TO group) for another 16 weeks.ResultsData from all patients in the CO group (n=165) and the TO group (n=152) were analyzed. Clinic and morning home BP and urinary albumin levels showed a significant decrease from baseline at 16 weeks after switching to olmesartan in both the CO and the TO group (clinic BP, morning home diastolic BP, and urinary albumin, P<0.05; morning home systolic BP, P<0.01). In contrast, clinic BP, morning home BP, and urinary albumin were significantly increased again 16 weeks after switching back to candesartan or telmisartan (clinic BP, morning home diastolic BP, and urinary albumin, P<0.05; morning home systolic BP, P<0.01). No subjects experienced an adverse reaction that required withdrawal from the study. No adverse reactions attributable to the study drugs were observed.ConclusionOlmesartan is a promising ARB for BP control in hypertensive type 2 diabetics.

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Effects of Olmesartan on the Renin-angiotensin-aldosterone System for Patients with Essential Hypertension after Cardiac Surgery—Investigation Using a Candesartan Change-over Study—

Cited by 10 publications

References 18 publications

Effects of Olmesartan and Azilsartan on Albuminuria and the Intrarenal Renin-Angiotensin System

Effects of Olmesartan and Azilsartan on Albuminuria and the Intrarenal Renin-Angiotensin System

High-dose nitrate therapy recovers the expression of subtypes α1 and β-adrenoceptors and Ang II receptors of the renal cortex in rats with myocardial infarction-induced heart failures

Difference in the effects of switching from Candesartan to Olmesartan or Telmisartan to Olmesartan in hypertensive patients with type 2 diabetes: the COTO study

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