Zhao Di, Liu Hui, Dong Pingshuan
Division of Hypertension, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, 24 Jinghua Avenue, Luoyang, 471003, China.
Division of Endocrinology, Luoyang Central Hospital Affiliated to Zhengzhou University, 288 Zhongzhouzhong Avenue, Luoyang, 471000, China.
Ir J Med Sci. 2019 May;188(2):481-488. doi: 10.1007/s11845-018-1859-1. Epub 2018 Jul 3.
The comparison of antihypertensive effects between azilsartan and olmesartan in patients with essential hypertension has been investigated in several studies. The results were not consistent. We performed this meta-analysis determining the antihypertensive effect of azilsartan versus olmesartan in patients with essential hypertension.
Pubmed, Web of Science, and Cochrane Central were searched for all published randomized studies comparing the antihypertensive effects between azilsartan and olmesartan in patients with essential hypertension.
The antihypertensive effects were assessed in 1402 patients included in five trials. The reduction of office systolic blood pressure treated with azilsartan was greater than olmesartan (weighted mean differences (WMD) - 2.15 (95% confidence interval (CI), - 3.78, - 0.53) mm Hg, p < 0.01). There was no significant difference in reduction of office diastolic blood pressure between azilsartan and olmesartan (WMD - 0.99 (95% CI, - 2.06, 0.08) mm Hg, p > 0.05). The reduction of office systolic blood pressure treated with azilsartan was greater than olmesartan at same dose for both drugs (WMD - 2.24 (95% CI, - 4.03, - 0.44) mm Hg, p < 0.05), whereas there was no significant difference in reduction of office diastolic blood pressure between azilsartan and olmesartan (WMD - 0.55 (95% CI, - 1.76, 0.66) mm Hg, p > 0.05).
This meta-analysis provides the evidence that the reduction of office systolic blood pressure treated with azilsartan was greater than olmesartan in patients with essential hypertension. These findings suggest the importance of strict designed randomized controlled trials in determining antihypertensive effects of angiotensin II receptor blockers in clinical practice.
多项研究对阿齐沙坦和奥美沙坦在原发性高血压患者中的降压效果进行了比较。结果并不一致。我们进行了这项荟萃分析，以确定阿齐沙坦与奥美沙坦在原发性高血压患者中的降压效果。
检索了PubMed、科学网和考克兰中央对照试验注册库，查找所有已发表的比较阿齐沙坦和奥美沙坦在原发性高血压患者中降压效果的随机研究。
五项试验纳入的1402例患者评估了降压效果。阿齐沙坦治疗的诊室收缩压降低幅度大于奥美沙坦（加权平均差（WMD）-2.15（95%置信区间（CI），-3.78，-0.53）mmHg，p<0.01）。阿齐沙坦和奥美沙坦在诊室舒张压降低方面无显著差异（WMD -0.99（95%CI，-2.06，0.08）mmHg，p>0.05）。两种药物在相同剂量下，阿齐沙坦治疗的诊室收缩压降低幅度大于奥美沙坦（WMD -2.24（95%CI，-4.03，-0.44）mmHg，p<0.05），而阿齐沙坦和奥美沙坦在诊室舒张压降低方面无显著差异（WMD -0.55（95%CI，-1.76，0.66）mmHg，p>0.05）。
这项荟萃分析提供的证据表明，在原发性高血压患者中，阿齐沙坦治疗的诊室收缩压降低幅度大于奥美沙坦。这些发现提示了严格设计的随机对照试验在临床实践中确定血管紧张素II受体阻滞剂降压效果方面的重要性。
