Efficacy and safety of a single-pill fixed-dose combination of high-dose telmisartan/hydrochlorothiazide in patients with uncontrolled hypertension

Shiga, Yuhei; Miura, Shin‐ichiro; Mitsutake, Ryoko; Norimatsu, Kenji; Nagata, I; Arimura, Tadaaki; Shimizu, Tomohiko; Morii, Joji; Kuwano, Takashi; Uehara, Yoshio; Inoue, Asao; Shirotani, Tetsuro; Fujisawa, Kazuaki; Matsunaga, Eiyu; Saku, Keijiro

doi:10.1177/1470320312439493

Cited by 9 publications

(10 citation statements)

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“…To our knowledge, however, there is no clinical report that telmisartan may decrease SUA level, whereas some clinical studies have shown a lowering effect of losartan on SUA level. In patients with hypertension, high-dose treatment with telmisartan for three months significantly increased SUA level [28]. In this study, we showed that long-term monotherapy with telmisartan increased SUA level.…”

Section: Discussionsupporting

confidence: 52%

Comparative effect of angiotensin II type I receptor blockers on serum uric acid in hypertensive patients with type 2 diabetes mellitus: a retrospective observational study

Nishida

Takahashi

Susa

et al. 2013

Cardiovasc Diabetol

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BackgroundAngiotensin II type 1 receptor blockers (ARB) are a frequently used class of antihypertensive drug. The ARB losartan is known to decrease the serum uric acid (SUA) level. However, there are very few clinical data comparing the effects of other ARBs on SUA level under the conditions of clinical practice. This study evaluated and compared the long-term effects of monotherapy with five ARBs on SUA level in Japanese hypertensive patients with type 2 diabetes mellitus (DM).MethodsWe identified hypertensive patients with type 2 DM who had been treated with monotherapy with losartan (n = 214), valsartan (n = 266), telmisartan (n = 185), candesartan (n = 458), or olmesartan (n = 192), in whom laboratory data of SUA between November 1, 2004 and July 31, 2011 were available, from the Nihon University School of Medicine’s Clinical Data Warehouse (NUSM’s CDW). We used a propensity-score weighting method and a multivariate regression model to adjust for differences in the background among ARB users, and compared the SUA level. The mean exposure of losartan was 264.7 days, valsartan 245.3 days, telmisartan 235.9 days, candesartan 248.9 days, and olmesartan 234.5 days.ResultsIn losartan users, mean SUA level was significantly decreased from baseline, while it was conversely increased in users of other ARBs; valsartan, telmisartan, candesartan, and olmesartan. The mean reduction of SUA level from baseline was significantly greater in losartan users compared with that in other ARB users. Comparison of ARBs other than losartan showed no significant difference in mean change in SUA level from baseline.ConclusionsOur study showed that losartan had the most beneficial effect on SUA level among five ARBs, and that there was no significant difference in the unfavorable effects on SUA level among four ARBs other than losartan, at least during one year. These findings provide evidence of an effect of ARBs on SUA level, and support the benefit of the use of losartan in hypertensive patients with type 2 DM.

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Section: Discussionsupporting

confidence: 52%

Comparative effect of angiotensin II type I receptor blockers on serum uric acid in hypertensive patients with type 2 diabetes mellitus: a retrospective observational study

Nishida

Takahashi

Susa

et al. 2013

Cardiovasc Diabetol

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“…Therefore, we divided the patients in the AZ group into 2 groups according to the normal range. 23,24) Our "relatively high UA" was defined as UA > 6.0 mg/dL, and "relatively low UA" was defined as 6.0 mg/dL ≥ UA. In AZ patients with relatively low UA, although the UA value at 3 months (5.1 ± 1.0 mg/dL) was significantly increased compared with the value at baseline (4.6 ± 1.0 mg/dL) (P < 0.01), the value was still within the normal range.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Efficacy and Safety of Azilsartan and Olmesartan in Patients With Essential Hypertension

et al. 2017

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SummaryMany patients still have high blood pressure (BP) after treatment with angiotensin II type 1 (AT 1 ) receptor blockers (ARBs). We compared the efficacy and safety of azilsartan to those of olmesartan in a prospective randomized clinical trial. Sixty-four hypertensive patients who were treated with ARBs other than azilsartan and olmesartan were enrolled in this study. We randomly assigned patients to changeover from their prior ARBs to either azilsartan or olmesartan, and followed the patients for 3 months. Systolic BP (SBP) in the azilsartan group was significantly decreased at 3 months, and diastolic BP (DBP) and pulse rate (PR) in the olmesartan group showed significant reductions after 3 months. There were no significant differences in ΔSBP, ΔDBP, or ΔPR (Δ = the value at 3 months minus the value at 0 months) between the groups. Serum levels of creatinine (Cr), uric acid (UA), and potassium (K) in the azilsartan group significantly increased after 3 months. While the changes in Cr, UA, and K were within the respective normal ranges, ΔSBP was positively associated with ΔCr in the azilsartan group. In conclusion, there was no difference in the depressor effects of azilsartan and olmesartan, and there were no serious changes in biochemical parameters with azilsartan and olmesartan. (Int Heart J 2017; 58: 416-421) Key words: Blood pressure, Angiotensin II type 1 receptor blocker, Uric acid S even types of angiotensin II type 1 (AT 1 ) receptor blockers (ARBs) have been developed and are available for clinical use in Japan.1) ARBs is effective in the treatment of cardiovascular disorders, including hypertension and heart failure.1,2) ARBs have been reported to have class-specific (common) and moleculespecific (differential) effects in basic experimental studies. 3)We have proposed that small differences in the molecular structures of ARBs could lead to differences in their abilities to influence the AT 1 receptor. 3,4) Azilsartan is the newest ARB to be approved for clinical use in Japan, and has a significant blood pressure (BP)-lowering effect, although the next generation ARBs could be a significant breakthrough in the field of cardiovascular medicine. 5)Azilsartan medoxomil and azilsartan have been reported to have greater antihypertensive effects than other ARBs.6-9) Azilsartan has been shown to bind tightly to and dissociate slowly from AT 1 receptors.10) Therefore, we hypothesized that the depressor effect of azilsartan may be superior to those of other ARBs in patients with hypertension (HTN). In this study, we performed a changeover from their prior ARBs to azilsartan or olmesartan in patients with hypertension, and compared the efficacy and safety of azilsartan to those of olmesartan in a prospective randomized clinical trial. MethodsStudy design: Sixty-four hypertensive patients who were treated with ARBs except for azilsartan and olmesartan were enrolled. We applied a changeover of ARBs, where patients were prospectively and randomly switched from their prior ARBs, except for azilsartan and ...

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“…Co ważne, wykazano, że połączenie dwulekowe oparte na tych dwóch substancjach jest skuteczniejsze niż monoterapia. Zastosowanie tego skojarzenia wiąże się nie tylko z istotniejszą redukcją wartości ciśnienia, ale także z większym odsetkiem pacjentów, u któ-rych udaje się osiągnąć docelowe wartości ciśnienia tętniczego krwi, co potwierdzono także w badaniach wykorzystujących ABPM w celu oceny efektu hipotensyjnego [52][53][54]. Połącze-nie dwulekowe oparte na telmisartanie jest skuteczniejsze niż to, w których podstawową składową był walsartan czy losartan (ryc.…”

Section: Telmisartan Jako Podstawowa Składowaunclassified

Telmisartan — skuteczny lek w zapobieganiu i leczeniu chorób układu sercowo-naczyniowego

Szymański

2014

Kardiol Pol

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WSTĘPChoroby układu sercowo-naczyniowego (CVD) niezmiennie, od wielu lat, pozostają główną przyczyną hospitalizacji i zgonów, zarówno w Europie, jak i na całym świecie [1,2].Skuteczne leczenie CVD w znacznej mierze zależy od kontroli czynników ryzyka. Jednym z najczęściej występujących w populacji polskiej czynników ryzyka jest nadciśnienie tętnicze. Redukcja wartości ciśnienia jest istotna dla zmniejszenia częstości występo-wania incydentów sercowo-naczyniowych, takich jak zawał serca (MI) czy udar mózgu oraz dla zmniejszenia ryzyka zgonu sercowo-naczyniowego (ryc. 1) [3].Wśród używanych obecnie w tym celu leków jedną z najczęściej stosowanych grup terapeutycznych są antagoniści receptora agniotensyny II, czyli sartany. Pierwszym zarejestrowanym wskazaniem do ich stosowania było leczenie nadciśnienia tętniczego, ale stopniowo, dzięki publikacji wyników kolejnych badań, wskazania rozszerzyły się. Wybierając korzystny dla pacjenta lek, za każdym razem należy się kierować zarówno skutecznością, jak i bezpieczeństwem potwierdzonym w dużych badaniach klinicznych. Można w tym miejscu postawić sobie kilka pytań: czy wszystkie sartany tak samo skutecznie redukują wartości ciśnienia tętniczego? czy wszystkie są tak samo bezpieczne? czy wszystkie mają takie same zarejestrowane wskazania?FARMAKODYNAMIKA I FARMAKOKINETYKA TELMISARTANU Antagoniści receptora angiotensyny II są jedną z grup leków oddziałujących na układ renina-angiotensyna-aldosteron (RAA). Mechanizm działania telmisartanu, podobnie jak innych leków z grupy sartanów, polega na blokowaniu receptora dla angiotensyny II (ryc. 2).W organizmie człowieka występuje kilka typów tych receptorów, spośród których najwięcej wiadomo o dwóch. Receptory typu 1 dla angiotensyny II (AT 1 ), które są zlokalizowane głównie w sercu, nadnerczach, mózgu, wątrobie i nerkach, oraz receptory typu 2 (AT 2 ). Ekspresja receptorów AT 2 jest wysoka u płodu i spada po narodzinach. U osób Rycina 1. Nadciśnienie tętnicze a ryzyko wystąpienia choroby wieńcowej, udaru mózgu, choroby naczyń obwodowych i niewydolności serca [na podstawie: Kannel WB, JAMA, 1996; 275: 1571-1576

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Efficacy and safety of a single-pill fixed-dose combination of high-dose telmisartan/hydrochlorothiazide in patients with uncontrolled hypertension

Abstract: High-dose telmisartan/HCTZ therapy was associated with a significant reduction in BP and helped patients achieve their target BP.

Cited by 9 publications

References 11 publications

Comparative effect of angiotensin II type I receptor blockers on serum uric acid in hypertensive patients with type 2 diabetes mellitus: a retrospective observational study

Comparative effect of angiotensin II type I receptor blockers on serum uric acid in hypertensive patients with type 2 diabetes mellitus: a retrospective observational study

Comparison of Efficacy and Safety of Azilsartan and Olmesartan in Patients With Essential Hypertension

Telmisartan — skuteczny lek w zapobieganiu i leczeniu chorób układu sercowo-naczyniowego

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