Antihypertensive activity of angiotensin II AT1 receptor antagonists: a systematic review of studies with 24 h ambulatory blood pressure monitoring

Abstract

Among the ARB, the influence is on duration more than on the magnitude of BP reduction. Dose, therefore, is an important factor in the duration of antihypertensive activity.

Antihypertensive efficacy and safety of olmesartan medoxomil and ramipril in elderly patients with mild to moderate essential hypertension: the ESPORT study

“…В частности, антигипер-тензивный эффект олмесартана медоксомила, по сравнению с рамиприлом, был более равномер-ным и продолжительным, что обеспечивало лучший контроль вариабельности артериального давления на протяжении всех суток, включая последние часы междозового интервала. Эти данные согласуются с результатами ранее выполненных исследований амбулаторного мониторирования артериального давления у молодых пациентов на фоне терапии олмесартаном медоксомилом [40][41][42]. Кроме того, в нашем исследовании, включившем относительно большое число пожилых больных с гипертензией, были подтверждены результаты недавно выполнен-ного открытого исследования, которое сравнивало эффективность 14-недельной терапии телмисарта-ном (80 мг/сут) и рамиприлом (5-10 мг/сут) у лиц с гипертензией 1-2 ст.…”

Effects of high dose olmesartan medoxomil plus hydrochlorothiazide on blood pressure control in patients with grade 2 and grade 3 hypertension

“…13 Such findings are inline with in vitro studies, which show that OM produces a strong blockade of the AT 1 receptor, with a high degree of insurmountable binding, slow dissociation and high affinity for the AT 1 receptor. 14 The clinical consequences of this robust inhibition of the AT 1 receptor appear as the sustained reductions in SBP and DBP over 24 h seen in the metaanalysis of Fabia et al 7 Direct clinical comparisons in which OM produced larger reductions in BP measured by ABPM than several other ARBs may also reflect stronger AT 1 receptor blockade [15][16][17] The 2009 re-appraisal of the ESH-ESC guidelines on hypertension management acknowledge that, in general, in up to 20% of patients with hypertension BP control cannot be achieved by a two-drug combination. 4 However, even treatment with an ARB with superior AT 1 receptor binding characteristics may not lead to high rates of BP goal achievement in a population that includes a high proportion of patients with severe hypertension.…”

“…8 It can also be seen in the meta-analysis of Fabia et al that the ARB olmesartan medoxomil (OM) provides effective BP reductions over 24-h, which are maintained during the night-time and last few hours of the dosing interval. 7 Pharmacodynamic studies support this notion 9,10 and treating patients with the high (40 mg) dose of olmesartan should provide a high level of AT 1 -receptor blockade leading to increased BP reductions and control.…”

“…3,4 The ESH-ESC guidelines do not provide recommendations on the individual members of drug classes, but recently a meta-analysis of ambulatory BP studies involving ARBs has shown that the drug used and its dose level are determinants of BP reduction. 7 However, differences in angiotensin II (AT 1 ) receptor blockade observed with the various ARBs have been explained mainly by differences in dosing. 8 It can also be seen in the meta-analysis of Fabia et al that the ARB olmesartan medoxomil (OM) provides effective BP reductions over 24-h, which are maintained during the night-time and last few hours of the dosing interval.…”

Effects of irbesartan on 24-h blood pressure changes and urinary albumin levels in Japanese outpatients

“…a meta-analysis involving 36 international studies showed that the effects on 24-h blood pressure changes depended on the type of arB (15). arB selection in anti-hypertensive treatment may be important for blood pressure control.…”