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Effect of azilsartan versus candesartan on morning blood pressure surges in Japanese patients with essential hypertension.

Abstract
Morning blood pressure (BP) surge is reported as a risk factor for cardiovascular events and end-organ damage independent of the 24-h BP level. Controlling morning BP surge is therefore important to help prevent onset of cardiovascular disease. We compared the efficacy of azilsartan and candesartan in controlling morning systolic BP (SBP) surges by analyzing relevant ambulatory BP monitoring data in patients with/without baseline BP surges. As part of a 16-week randomized, double-blind study of azilsartan (20-40 mg once daily) and candesartan (8-12 mg once daily) in Japanese patients with essential hypertension, an exploratory analysis was carried out using ambulatory BP monitoring at baseline and week 14. The effects of study drugs on morning BP surges, including sleep trough surge (early morning SBP minus the lowest night-time SBP) and prewaking surge (early morning SBP minus SBP before awakening), were evaluated. Patients with sleep trough surge of at least 35 mmHg were defined by the presence of a morning BP surge (the 'surge group'). Sleep trough surge and prewaking surge data were available at both baseline and week 14 in 548 patients, 147 of whom (azilsartan 76; candesartan 71) had a baseline morning BP surge. In surge group patients, azilsartan significantly reduced both the sleep trough surge and the prewaking surge at week 14 compared with candesartan (least squares means of the between-group differences -5.8 mmHg, P=0.0395; and -5.7 mmHg, P=0.0228, respectively). Once-daily azilsartan improved sleep trough surge and prewaking surge to a greater extent than candesartan in Japanese patients with grade I-II essential hypertension.
AuthorsHiromi Rakugi, Kazuomi Kario, Kazuaki Enya, Kenkichi Sugiura, Yoshinori Ikeda
JournalBlood pressure monitoring (Blood Press Monit) Vol. 19 Issue 3 Pg. 164-9 (Jun 2014) ISSN: 1473-5725 [Electronic] England
PMID24710336 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antihypertensive Agents
  • Benzimidazoles
  • Biphenyl Compounds
  • Oxadiazoles
  • Tetrazoles
  • azilsartan
  • candesartan
Topics
  • Aged
  • Antihypertensive Agents (administration & dosage)
  • Asian People
  • Benzimidazoles (administration & dosage)
  • Biphenyl Compounds
  • Blood Pressure (drug effects)
  • Double-Blind Method
  • Essential Hypertension
  • Female
  • Humans
  • Hypertension (drug therapy, physiopathology)
  • Japan
  • Male
  • Middle Aged
  • Oxadiazoles (administration & dosage)
  • Tetrazoles (administration & dosage)

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