Kakio Yuki, Uchida Haruhito A, Umebayashi Ryoko, Takeuchi Hidemi, Okuyama Yuka, Hanayama Yoshihisa, Wada Jun
Departments of aNephrology, Rheumatology, Endocrinology and Metabolism bChronic Kidney Disease and Cardiovascular Disease cGeneral Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Blood Press Monit. 2017 Apr;22(2):59-67. doi: 10.1097/MBP.0000000000000229.
Olmesartan and azilsartan, angiotensin II receptor blockers (ARBs), are expected to decrease blood pressure more than the other ARBs. We conducted randomized-controlled trials to compare the practical efficacy of olmesartan with azilsartan.
Eighty-four patients treated with the conventional ARBs for more than 3 months were assigned randomly to receive either 20 mg of olmesartan (olmesartan medoxomil, OL group) or 20 mg of azilsartan (azilsartan, not azilsartan medoxomil, AZ group) once daily for 16 weeks. The practical efficacy on blood pressure was compared between the OL and AZ groups.
Office blood pressure of both groups decreased significantly (OL group: 152/86-141/79 mmHg, P<0.05, AZ group: 149/83-135/75 mmHg; P<0.05). Diastolic home blood pressure in the AZ group decreased significantly (79±9-74±7 mmHg; P<0.05), but not in the OL group (79±11-75±10 mmHg; P=0.068). However, there were no significant differences between the groups. The dosage of olmesartan and azilsartan increased significantly and slightly for 16 weeks (OL group: 20.3-23.1 mg; P<0.05, AZ group: 20.5-23.2 mg; P<0.05), without a significant difference between groups. Furthermore, there were no significant differences in renal function, lipid profiles, brain natriuretic peptide, soluble fms-like tyrosine kinase-1, and urinary L-type fatty acid-binding protein between the two groups.
Both olmesartan and azilsartan equally reduced blood pressures. Both olmesartan and azilsartan showed a renoprotective effect and were well tolerated without any major adverse events.
奥美沙坦和阿齐沙坦均为血管紧张素II受体阻滞剂（ARB），预期二者比其他ARB类药物能更有效地降低血压。我们开展了随机对照试验，比较奥美沙坦与阿齐沙坦的实际疗效。
将84例接受传统ARB类药物治疗超过3个月的患者随机分组，分别每日服用20毫克奥美沙坦（奥美沙坦酯，OL组）或20毫克阿齐沙坦（阿齐沙坦，而非奥美沙坦酯，AZ组），持续16周。比较OL组和AZ组对血压的实际疗效。
两组的诊室血压均显著下降（OL组：152/86 - 141/79 mmHg，P<0.05；AZ组：149/83 - 135/75 mmHg；P<0.05）。AZ组的家庭舒张压显著下降（79±9 - 74±7 mmHg；P<0.05），而OL组未显著下降（79±11 - 75±10 mmHg；P = 0.068）。然而，两组之间无显著差异。16周内，奥美沙坦和阿齐沙坦的剂量均显著增加（OL组：20.3 - 23.1毫克；P<0.05，AZ组：20.5 - 23.2毫克；P<0.05），但两组之间无显著差异。此外，两组在肾功能、血脂谱、脑钠肽、可溶性fms样酪氨酸激酶-1和尿L型脂肪酸结合蛋白方面无显著差异。
奥美沙坦和阿齐沙坦在降低血压方面效果相当。二者均显示出肾脏保护作用，耐受性良好，未发生任何严重不良事件。
