Patients With Newly Diagnosed Hypertension Treated With the Renin Angiotensin Receptor Blocker Azilsartan Medoxomil vs Angiotensin‐Converting Enzyme Inhibitors: The Prospective EARLY Registry

Abstract

For patients with newly diagnosed hypertension, angiotensin‐converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are usually the first‐line therapies. There is, however, no real‐life data regarding the relative clinical effectiveness and tolerability of either drug class. The prospective registry, Treatment With Azilsartan Compared to ACE Inhibitors in Antihypertensive Therapy (EARLY), was conducted to evaluate the effectiveness of the ARB azilsartan medoxomil (AZL‐M) vs ACE inhibitors in real‐world patients. Of the 1153 patients with newly diagnosed hypertension who were included in the registry, 789 were prescribed AZL‐M and 364 were prescribed an ACE inhibitor. After multivariate adjustment, AZL‐M was found to provide superior blood pressure reduction and better target blood pressure (<140/90 mm Hg) achievement. The proportion of patients with adverse events was not statistically different between groups. The authors conclude that in newly diagnosed hypertensive patients, AZL‐M provides superior blood pressure control with a similar safety profile compared with ACE inhibitors.

Is Azilsartan More Effective in Younger Than in Older Patients? An Explorative Analysis of the Prospective EARLY Registry

“…Roland E. Schmieder, MD; 1, * Peter Bramlage, MD; 2 for the EARLY Registry Group From the 1 Universit€ atsklinikum Erlangen, Erlangen, Germany; 2 Institut f€ ur Pharmakologie und pr€ aventive Medizin, Mahlow, Germany…”

Will Azilsartan - An Eight ARB Bring Paradigm Shift in Hypertension Management Practices in India?

“…Azilsartan also improved the non-dipping pattern in nocturnal hypertension. Also can be combine with other anti-hypertensives like Chlorthalidione and or Amlodipine [12]. However, unlike other ARB's, Azilsartan is not backed up by clinical data supporting its ability to affect improvement in cardiovascular outcomes and is not approved for diabetic nephropathy or heart failure till date [14].…”

“…A starting dose of 20 mg may be considered for very elderly (aged more than 75 years) patients who may be at risk of hypotension [9]. Treatment of hypertensive patients using Azilsartan appears to be more effective in younger than in older patients [11,12].…”

Renin‐Angiotensin System Inhibitors: Do They Have the Same Impact at All Ages?

“…We read with real interest the study by Schmieder and colleagues, 1 which provides important data on the efficacy of the angiotensin receptor blocker (ARB) azilsartan over the angiotensin-converting enzyme (ACE) inhibitor ramipril in blood pressure (BP) reduction in patients with hypertension. Furthermore, the authors showed greater decreases in BP in the patients with newly diagnosed hypertension vs the group with established hypertension, while target BP control was achieved more frequently in the first aforementioned group.…”

“…Furthermore, the authors showed greater decreases in BP in the patients with newly diagnosed hypertension vs the group with established hypertension, while target BP control was achieved more frequently in the first aforementioned group. 1 The potency of ACE inhibitors and ARBs in decreasing BP has been sufficiently proven; however, results from various studies have provided contradictory results on the efficacy of these agents in older vs younger patients. [2][3][4][5] We therefore believe that a subgroup analysis according to age would provide significant information about the management of hypertensive patients in real-life everyday clinical practice.…”