Okamura Keisuke, Shirai Kazuyuki, Okuda Tetsu, Urata Hidenori
Department of Cardiovascular Diseases, Fukuoka University Chikushi Hospital, Chikushino, Japan.
J Clin Med Res. 2018 Jan;10(1):41-49. doi: 10.14740/jocmr3228w. Epub 2017 Dec 1.
Azilsartan is an angiotensin II receptor blocker with a potent antihypertensive effect.
In a multicenter, prospective, open-label study, 265 patients with poor blood pressure control despite treatment with other angiotensin II receptor blockers were switched to 20 mg/day of azilsartan (patients on standard dosages) or 40 mg/day of azilsartan (patients on high dosages).
Blood pressure was 149/83 mm Hg before switching and was significantly reduced from 1 month after switching until final assessment (132/76 mm Hg, P < 0.001). The pulse rate was 72/min before switching and increased significantly from 3 months after switching until final assessment (74/min, P < 0.005). A significant decrease of home morning systolic and diastolic pressure was observed from 1 and 3 months, respectively. Home morning blood pressure was 143/82 mm Hg before switching and 130/76 mm Hg at final assessment (P < 0.01). The morning-evening difference of systolic blood pressure decreased from 14.6 to 6.6 mm Hg after switching (P = 0.09). The estimated glomerular filtration rate was significantly decreased at 3, 6, and 12 months after switching, and serum uric acid was significantly increased at 12 months. No serious adverse events occurred.
Azilsartan significantly reduced the blood pressure and decreased diurnal variation in patients responding poorly to other angiotensin II receptor blockers.
阿齐沙坦是一种具有强效降压作用的血管紧张素II受体阻滞剂。
在一项多中心、前瞻性、开放标签研究中，265例尽管使用其他血管紧张素II受体阻滞剂治疗但血压控制不佳的患者，被换用阿齐沙坦20毫克/天（标准剂量患者）或40毫克/天（高剂量患者）。
换药前血压为149/83毫米汞柱，换药后1个月至最终评估时显著降低（132/76毫米汞柱，P<0.001）。换药前脉搏率为72次/分钟，换药后3个月至最终评估时显著升高（74次/分钟，P<0.005）。分别在换药后1个月和3个月观察到家庭晨起收缩压和舒张压显著下降。换药前家庭晨起血压为143/82毫米汞柱，最终评估时为130/76毫米汞柱（P<0.01）。换药后收缩压的早晚差值从14.6毫米汞柱降至6.6毫米汞柱（P=0.09）。换药后3、6和12个月时估计肾小球滤过率显著降低，12个月时血清尿酸显著升高。未发生严重不良事件。
阿齐沙坦可显著降低对其他血管紧张素II受体阻滞剂反应不佳患者的血压，并减少昼夜血压变化。
