Efficacy of Allisartan Isoproxil in the Treatment of Mild-to-Moderate Essential Hypertension

Wang, Hongyi; Xi, Yang; Chen, Y.; Wang, Luyan; Yang, Fan; Lu, Xinyuan; Sun, Ningling

doi:10.1093/ajh/hpad055

Cited by 4 publications

(6 citation statements)

References 9 publications

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“…These results indicate that, in addition to blocking the activity of renin-angiotensin-aldosterone system (RAAS), allisartan may also exert these effects via other auxiliary mechanisms. Clinical studies have demonstrated that allisartan could effectively reduce the serum uric acid (UA) level in hypertensive patients with hyperuricemia [ 94 , 95 ]. Animal studies in zebrafish hyperuricemia model have shown that allisartan could significantly upregulate intestinal urate transporters such as ABCG2, PDZK1, and SLC2A9, which might be the possible mechanism of UA reduction [ 96 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of angiotensin receptor blockers for nocturnal blood pressure reduction: a systematic review and meta-analysis

Liu,

Chen,

Shao

et al. 2024

Annals of Medicine

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Background Nocturnal blood pressure (BP) is correlated with an increased risk of cardiovascular events and is an important predictor of cardiovascular death in hypertensive patients. Objective Nocturnal BP control is of great importance for cardiovascular risk reduction. This systematic review and meta-analysis aimed to explore the efficacy of angiotensin receptor blockers (ARBs) for nocturnal BP reduction in patients with mild to moderate hypertension. Methods PICOS design structure was used to formulate the data extraction. All statistical calculations and analyses were performed with R. Results Seventy-seven studies with 13,314 participants were included. The overall analysis indicated that nocturnal BP drop varied considerably among different ARBs. Allisartan (13.04 [95% CI (−18.41, −7.68)] mmHg), olmesartan (11.67 [95% CI (−14.12, −9.21)] mmHg), telmisartan (11.11 [95% CI (−12.12, −10.11)] mmHg) were associated with greater reduction in nocturnal systolic BP. In the aspect of the nocturnal-diurnal BP drop ratio, only allisartan was greater than 1. While, the variation tendency of last 4–6 h ambulatory BP was basically consistent with nocturnal BP. Additionally, allisartan showed improvement effect in the proportion of patients with dipping BP pattern. Conclusions This study demonstrates that for patients with mild to moderate hypertension, allisartan, olmesartan and telmisartan have more advantages in nocturnal BP reduction among the ARBs, while allisartan can reduce nighttime BP more than daytime BP and improve the dipping pattern.

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Section: Discussionmentioning

confidence: 99%

Efficacy of angiotensin receptor blockers for nocturnal blood pressure reduction: a systematic review and meta-analysis

Liu,

Chen,

Shao

et al. 2024

Annals of Medicine

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“…Guidelines for hypertension management commonly recommend combination therapy involving a renin-angiotensin system inhibitor with a calcium channel blocker or combined diuretic ( 43 ). A multicenter, prospective, open phase IV clinical trial conducted by Wang et al ( 27 ) investigated the antihypertensive efficacy of Allisartan Isoproxil combined with indapamide or amlodipine in patients who did not meet monotherapy standards. From baseline to 12 weeks, SBP decreased by 19.1 ± 11.7 mmHg and DBP decreased by 10.8 ± 8.7 mmHg.…”

Section: Discussionmentioning

confidence: 99%

“…Preclinical studies have demonstrated its ability to lower blood pressure, mitigate inflammation and oxidative stress, and improve cardiac remodeling and cardiac dysfunction with minimal toxicity ( 26 ). Several clinical studies have demonstrated the favorable antihypertensive impact of Allisartan Isoproxil on mild to moderate essential hypertension, highlighting its safety and effectiveness in blood pressure reduction and organ protection ( 27 , 28 ). Nonetheless, despite these promising outcomes, the existing evidence base remains inadequately substantiated.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety evaluation of Allisartan Isoproxil in patients with hypertension: a meta-analysis

Zhao,

Liu,

Chen

2024

Front. Cardiovasc. Med.

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ObjectiveThis study aimed to evaluate the effectiveness and safety of Allisartan Isoproxil in the management of hypertension.MethodsA comprehensive search was conducted across both English and Chinese databases, including the Cochrane Library, Embase, PubMed, Web of Science, Chinese Journal Full Text Database (CNKI), Wanfang Digital Periodical Full Text Database, and VIP Chinese Periodical Database (VIP), up to March 24, 2024. Randomized controlled trials (RCTs) investigating alisartan axetil for hypertension management were selected. Literature quality was assessed, and data were extracted for meta-analysis using Stata 15.1 software. The quality of evidence for outcome indicators was evaluated using the GRADE system level.ResultsSix RCTs involving 767 participants were included. Meta-analysis revealed that, compared to placebo, the Allisartan Isoproxil group exhibited a significant reduction in systolic blood pressure (SBP) [WMD = −8.08, 95% CI (−11.81, 4.10), p = 0.000] and brachial-ankle pulse wave velocity (baPWV) [SMD = −0.69, 95% CI (−1.17, 0.20), p = 0.006]. However, the reduction in diastolic blood pressure (DBP) was not statistically significant [WMD = −5.48, 95% CI (−11.07, 0.10), p = 0.054]. Additionally, compared to calcium channel blockers (CCB) and angiotensin II receptor blockers (ARB), Allisartan Isoproxil did not significantly affect SBP [WMD = 0.20, 95% CI (−3.71, 4.10), p = 0.921] or DBP [WMD = 0.16, 95% CI (−2.11, 2.43), p = 0.891]. Allisartan Isoproxil demonstrated superior effects in increasing nitric oxide (NO) levels and decreasing endothelin (ET) levels compared to control groups [WMD = 9.56, 95% CI (6.42, 12.71), p = 0.000], [WMD = −7.42, 95% CI (−11.13, −3.71), p = 0.000], and showed a higher effective control rate of blood pressure [RR = 1.26, 95% CI (1.13, 1.41), p = 0.000]. Subgroup analysis did not reveal significant differences. Regarding safety, there were no statistically significant differences in adverse events between the Allisartan Isoproxil group and the control groups [RR = 0.99, 95% CI (0.74, 1.32), p = 0.928], and no fatal adverse events were reported.ConclusionAllisartan Isoproxil is effective in reducing SBP and baPWV, increasing NO, decreasing ET, and achieving a higher control rate of blood pressure in patients with essential hypertension. These benefits are achieved with minimal adverse reactions.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023467869, identifier PROSPERO CRD42023467869.

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“…According to a study of 24‐h ABPM, after oral administration of 240 mg allisartan isoproxil once a day in the morning for 12 weeks, daytime and nighttime ambulatory BP decreased by 9.9/5.4 and 10.4/5.4 mm Hg, respectively. 77 In addition to blocking the renin‐angiotensin‐aldosterone system (RAAS), the dominant effect of allisartan isoproxil on reducing nighttime BP may be related to its effects on reduction of uric acid and sodium reabsorption. 78 …”

Section: Treatmentmentioning

confidence: 99%

Management of nocturnal hypertension: An expert consensus document from Chinese Hypertension League

Liu,

Li,

Zhang

et al. 2023

J of Clinical Hypertension

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Nocturnal hypertension is highly prevalent among Chinese and Asian populations, which is mainly attributed to high salt intake and high salt sensitivity. Nocturnal hypertension increases the risk of cardiovascular and all‐cause mortality, independent of daytime blood pressure (BP). However, it can usually be detected by 24‐h ambulatory BP monitoring, rather than routine office or home BP measurement, thus is often underdiagnosed in clinical practice. Currently, no specific guidance is available for the management of nocturnal hypertension in China or worldwide. Experts from the Chinese Hypertension League summarized the epidemiologic and pathophysiologic characteristics and clinical phenotype of nocturnal hypertension and provided consensus recommendations on optimal management of nocturnal hypertension, with the goal of maximally reducing the cardiovascular disease risks. In this consensus document, 24‐h ABPM is recommended for screening and diagnosis of nocturnal hypertension, especially in the elderly, patients with diabetes, chronic kidney diseases, obstructive sleep apnea and other conditions prone to high nocturnal BP. Lifestyle modifications including salt intake restriction, exercise, weight loss, sleep improvement, and mental stress relief are recommended. Long‐acting antihypertensive medications are preferred for nocturnal and 24‐h BP control. Some newly developed agents, renal denervation, and other device‐based therapy on nocturnal BP reduction are evaluated.

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Efficacy of Allisartan Isoproxil in the Treatment of Mild-to-Moderate Essential Hypertension

Cited by 4 publications

References 9 publications

Efficacy of angiotensin receptor blockers for nocturnal blood pressure reduction: a systematic review and meta-analysis

Efficacy of angiotensin receptor blockers for nocturnal blood pressure reduction: a systematic review and meta-analysis

Efficacy and safety evaluation of Allisartan Isoproxil in patients with hypertension: a meta-analysis

Management of nocturnal hypertension: An expert consensus document from Chinese Hypertension League

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