Effect of angiotensin II receptor blockers on blood pressure changes at daily monitoring depending on morning or evening reception

Abstract

The aim – to evaluate the effect of angiotensin II receptor blockers olmesartan, azilsartan and telmisartan when administered in the morning or evening hours on blood pressure (BP) indices during daily monitoring in patients with arterial hypertension (AH).
Materials and methods. The study involved 126 patients with mild to moderate hypertension who were selected to compare the effect of angiotensin II receptor blockers – olmesartan, azilsartan and telmisartan – in the morning and evening hours. They were divided into 6 groups: 20 patients taking olmesartan at a dose of 20–40 mg in the morning,
20 patients taking olmesartan at a dose of 20–40 mg in the evening, 21 patients taking azilsartan at a dose of 40–80 mg in the morning, 20 patients taking azilsartan at a dose of 40–80 mg in the evening, 22 patients taking telmisartan at a dose of 40–80 mg in the morning, 23 patients taking telmisartan at a dose of 40–80 mg in the evening. Patients underwent primary examination and repeated one – after 3 months of therapy.
Results and discussion. Evening reception of olmesartan, compared with morning one, led to a more pronounced decrease in diurnal systolic blood pressure (SBT) – (11.09±2.30) vs (4.06±2.25) mm Hg (p<0.01). Changes in diurnal diastolic blood pressure (DBP) were statistically insignificant, although its decrease during evening reception was more significant compared to decrease during morning reception ((8.38±2.58) mm Hg versus (3.38±2.31) mm Hg). Changes in daily blood pressure against reception of azilsartan in the evening and morning hours were statistically significant, but did not differ from each other ((13.06±2.65)/(9.76±1.73) vs. (12.71±1.62)/(7.00±1.50) mm Hg). Reduction of diurnal blood pressure at the background of telmisartan administration was statistically significantly more pronounced in the morning than in the evening intake ((16.48±2.86)/(12.56±2.80) vs. (4.93±1.53)/(5.40±1.89) mm Hg, p<0.01). Thus, morning reception more significantly lowered the average daily blood pressure against the background of taking telmisartan, and the evening reception – against the background of taking olmesartan. Azilsartan equally reduced the blood pressure both at evening and morning admission. The rate of achievement of target BP at daily monitoring against the background of the administration of olmesartan, azilsartan and telmisartan was 71.80; 71.0 and 75.61 %, respectively.
Conclusions. Admission of telmisartan more significantly reduced the average daily blood pressure in morning hours compared to evening hours, olmesartan better lowered the average daily blood pressure when taken in the evening, and the use of azilsartan equally affected the decrease in blood pressure regardless of the time of taking the drug.