Role of olmesartan in combination therapy in blood pressure control and vascular function

Abstract

Angiotensin receptor blockers have emerged as a first-line therapy in the management of hypertension and hypertension-related comorbidities. Since national and international guidelines have stressed the need to control blood pressure to <140/90 mmHg in uncomplicated hypertension and <130/80 mmHg in those with associated comorbidities such as diabetes or chronic kidney disease, these goal blood pressures can only be achieved through combination therapy. Of several drugs that can be effectively combined to attain the recommended blood pressure goals, fixed-dose combinations of angiotensin receptor blockers and the calcium channel blocker amlodipine provide additive antihypertensive effects associated with a safe profile and increased adherence to therapy. In this article, we review the evidence regarding the beneficial effects of renin–angiotensin system blockade with olmesartan medoxomil and amlodipine in terms of blood pressure control and improvement of vascular function and target organ damage.

Predominance of AT1 Blockade Over Mas–Mediated Angiotensin-(1–7) Mechanisms in the Regulation of Blood Pressure and Renin–Angiotensin System in mRen2.Lewis Rats

“…Moreover, previous studies also showed that Ang-(1-7) effects are mediated through receptors other then mas, for example AT 2 . 20 Finally, Ang-(1-7), like olmesartan, 1,30,31 may elicit inverse agonist effect on AT 1 -Rs. Thus, Ang-(1-7) and olmesartan may have overlapping activities at the AT 1 -Rs and that may be why A-779 has no apparent blood pressure effect when given together with olmesartan.…”

Effects of an Angiotensin 2 Receptor Blocker plus Diuretic Combination Drug in Chronic Heart Failure Complicated by Hypertension

“…It has previously been shown that reducing the pill burden improves patient compliance. 27,28 Furthermore, improvements in blood pressure as a result of better patient compliance have also been reported. 29,30 In the present study, a marked hypotensive O Suzuki, H Ishii, S Kobayashi ARB/diuretic combination for chronic heart failure with hypertension effect was obtained by replacing RAA system inhibitors with the candesartan 8 mg plus hydrochlorothiazide 6.25 mg combination tablet; however, compliance was not specifically measured in this study, therefore no firm conclusions can be drawn regarding compliance, reduction in number of drugs taken and improvements in blood pressure from these data.…”

“…It has previously been shown that reducing the pill burden improves patient compliance. 27,28 Furthermore, improvements in blood pressure as a result of better patient compliance have also been reported. 29,30 In the present study, a marked hypotensive 1 (1.6) Emphysema-associated left 1 (1.6) and right heart failure Diabetes mellitus 17 (27.9) Brain infarction 9 (14.8) Angina pectoris 13 (21.3) Urinary bladder carcinoma 3 (4.9) Gastric ulcer 1 (1.6) Colorectal cancer 1 (1.6) Renal failure 4 (6.6) Anaemia 2 (3.3) Aortic dissection 1 (1.6) Lung cancer 1 (1.6) Asthma 1 (1.6) Previous smoker 6 (10.8)…”

Pathophysiologic Aspects of Hypertension

“…(1) increased sympathetic nervous system activity, possibly related to increased responsiveness to psychosocial stress; (2) overproduction of sodium-retaining hormones and vasoconstrictors such as endothelin or thromboxane; (3) increased sodium intake; (4) inappropriate secretion of renin; and (5) decreased production of vasodilating substances such as nitric oxide or prostaglandins [2,5,38,40].…”

“…High blood pressure (hypertension) is one of the most common chronic medical conditions in the developed world and is rapidly becoming a major problem in developing countries. It is estimated that about 20% of the world's adult population, or some 690 million adults, suffer from hypertension [1][2][3]. Blood pressure in the population is normally distributed in a bell-shaped curve with a slight skew towards higher readings (Figure 1).…”