Comparative antihypertensive efficacy of olmesartan: comparison with other angiotensin II receptor antagonists.
Hypertension is a major risk factor for cardiovascular morbidity and mortality. Effective control of elevated blood pressure (BP) has been shown to reduce this risk. Early studies of risk reduction assumed that the mechanism by which BP was lowered had little impact on the benefit obtained. Recent evidence, however, suggests that agents that inhibit the renin-angiotensin system may be particularly beneficial. The results of the recent Heart Outcomes Prevention Evaluation (HOPE) trial suggest that angiotensin-converting enzyme (ACE) inhibitors have a greater impact on cardiovascular morbidity and mortality than would be anticipated from their antihypertensive effects alone. Angiotensin receptor blockers, the other major class of antihypertensive drugs that inhibit the renin-angiotensin system, have not been widely tested in outcomes trials, but early results suggest that they are beneficial for controlling target organ damage that is related to hypertension. Furthermore, unlike ACE inhibitors, these agents have a side-effect profile that is similar to that of placebo. Based on their efficacy in controlling hypertension and their wider health benefits, together with minimal side effects, angiotensin II (A II) receptor blockers should be considered as first-line agents for the treatment of hypertension, particularly in patients with other cardiovascular risk factors. Preliminary evidence suggests that olmesartan, an A II receptor blocker currently being evaluated for approval for clinical use, may provide antihypertensive efficacy that is superior to other members of the class.
Oparil
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Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Dept. of Medicine, University of Alabama at Birmingham, 1034 Zeigler Research Building, Birmingham, AL 35294, USA. soparil@uab.edu
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007093:Imidazoles / Q000627:therapeutic use*; D000068557:Olmesartan Medoxomil; D016032:Randomized Controlled Trials as Topic; D013777:Tetrazoles / Q000627:therapeutic use*
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics; D007093:Imidazoles; D013777:Tetrazoles; D000068557:Olmesartan Medoxomil