title: Antihypertensive efficacy of the angiotensin receptor blocker azilsartan medoxomil compared with the angiotensin-converting enzyme inhibitor ramipril.
abstract: Drug therapy often fails to control hypertension. Azilsartan medoxomil (AZL-M) is a newly developed angiotensin II receptor blocker with high efficacy and good tolerability. This double-blind, controlled, randomised trial compared its antihypertensive efficacy and safety vs the angiotensin-converting enzyme inhibitor ramipril (RAM) in patients with clinic systolic blood pressure (SBP) 150-180 mm Hg. Patients were randomised (n=884) to 20 mg AZL-M or 2.5 mg RAM once daily for 2 weeks, then force-titrated to 40 or 80 mg AZL-M or 10 mg RAM for 22 weeks. The primary endpoint was change in trough, seated, clinic SBP. Mean patient age was 57±11 years, 52.4% were male, 99.5% were Caucasian. Mean baseline BP was 161.1±7.9/94.9±9.0 mm Hg. Clinic SBP decreased by 20.6±0.95 and 21.2±0.95 mm Hg with AZL-M 40 and 80 mg vs12.2±0.95 mm Hg with RAM (P<0.001 for both AZL-M doses). Adverse events leading to discontinuation were less frequent with AZL-M 40 and 80 mg (2.4% and 3.1%, respectively) than with RAM (4.8%). These data demonstrated that treatment of stage 1-2 hypertension with AZL-M was more effective than RAM and better tolerated.
authors.affiliation: Park-Klinikum Bad Krozingen, Herbert-Hellmann-Allee 44, Bad Krozingen, Germany. g.boenner@park-klinikum.de
authors.forename: G
authors.initials: G
authors.lastname: Bönner
authors.forename: G L
authors.initials: GL
authors.lastname: Bakris
authors.forename: D
authors.initials: D
authors.lastname: Sica
authors.forename: M A
authors.initials: MA
authors.lastname: Weber
authors.forename: W B
authors.initials: WB
authors.lastname: White
authors.forename: A
authors.initials: A
authors.lastname: Perez
authors.forename: C
authors.initials: C
authors.lastname: Cao
authors.forename: A
authors.initials: A
authors.lastname: Handley
authors.forename: S
authors.initials: S
authors.lastname: Kupfer
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010069:Oxadiazoles / Q000627:therapeutic use*; D017257:Ramipril / Q000627:therapeutic use*
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D010069:Oxadiazoles; D017257:Ramipril; C557413:azilsartan medoxomil