Shiga Yuhei, Miura Shin-Ichiro, Motozato Kota, Norimatsu Kenji, Yano Masaya, Hitaka Yuka, Adachi Sen, Kuwano Takashi, Inoue Ken, Inoue Asao, Fujisawa Kazuaki, Shirotani Tetsuro, Kusumoto Takaaki, Ideishi Munehito, Saku Keijiro
Department of Cardiology, Fukuoka University School of Medicine.
Inoue Hospital.
Int Heart J. 2017 May 31;58(3):416-421. doi: 10.1536/ihj.16-285. Epub 2017 May 12.
Many patients still have high blood pressure (BP) after treatment with angiotensin II type 1 (AT) 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.
许多患者在接受1型血管紧张素II（AT）受体阻滞剂（ARB）治疗后仍患有高血压（BP）。我们在一项前瞻性随机临床试验中比较了阿齐沙坦与奥美沙坦的疗效和安全性。本研究纳入了64例接受除阿齐沙坦和奥美沙坦之外的ARB治疗的高血压患者。我们随机分配患者从之前使用的ARB转换为阿齐沙坦或奥美沙坦，并对患者进行了3个月的随访。阿齐沙坦组的收缩压（SBP）在3个月时显著降低，奥美沙坦组的舒张压（DBP）和脉搏率（PR）在3个月后显著降低。两组之间的ΔSBP、ΔDBP或ΔPR（Δ = 3个月时的值减去0个月时的值）无显著差异。阿齐沙坦组的血清肌酐（Cr）、尿酸（UA）和钾（K）水平在3个月后显著升高。虽然Cr、UA和K的变化在各自的正常范围内，但阿齐沙坦组的ΔSBP与ΔCr呈正相关。总之，阿齐沙坦和奥美沙坦的降压效果无差异，使用阿齐沙坦和奥美沙坦时生化参数无严重变化。
