Impact of angiotensin II receptor blockers on changes in office, central blood pressure and circadian blood pressure in relation to morning or evening reception
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Abstract
The aim – to evaluate the effect of angiotensin II receptor blockers – olmesartan, azilsartan and telmisartan – taken in the morning or evening hours, on office, central blood pressure under daily monitoring and to assess circadian blood pressure.
Materials and methods. The study included 126 patients with mild to moderate hypertension that were selected to compare the effect of drug pharmacotherapy with angiotensin II receptor blockers – olmesartan, azilsartan and telmisartan on morning and evening hours. Patients were distributed into 6 groups: 1st group 20 patients taking olmesartan 20–40 mg in the morning, 2nd group – 20 patients taking olmesartan 20–40 mg in the evening hours, 3rd – 21 patients taking azilsartan 40–80 mg in the morning, 4th – 20 patients taking azilsartan 40–80 mg in the evening, 5th – 22 patients taking telmisartan 40–80 mg in the morning, 6th – patients taking telmisartan 40–80 mg in the evening. Patients underwent primary and re-examination followed 3 months of the therapy.
Results and discussion. Lowering of office SBP/DBP in the olmesartan intake group in the evening hours was – 20.95/13.50 mm Hg (p<0.05), and when taken in the morning hours – 19.40/8.95 mm Hg (p<0.05). In the group of azіlsartan therapy, the lowering of office SBP/DBP in the evening hours was 21.10/11.50 mm Hg (p<0.05), and taken in the morning hours – 20.05/12.23 mm Hg (p<0.05). In the telmisartan intake group, the lowering of office SBP/DBP during in the evening was 19.54/9.00 mm Hg (p<0.05), and taken in the morning hours – 21.22/12.29 mm Hg (p<0.05). Lowering of central blood pressure was equally effective and did not depend on the time of taking the drugs. Lowering of central SBP with olmesartan intake was 3 months after administration in the evening hours – 18.34 mm Hg, in the morning – 15.22 mm Hg, while taking azilsartan – respectively 15.59 and 19.24 mm Hg, while taking telmisartan – respectively 12.00 and 18.00 mm Hg. Reaching of the target office blood pressure with olmesartan therapy was observed in 77.50 % of patients, with azilsartan in 78.05 % of patients, and with telmisartan in 78.57 % of patients. The intake of olmesartan, azilsartan and telmisartan did not statistically significantly affect the circadian blood pressure.
Conclusions. The use of olmesartan, azilsartan and telmisartan equally effectively lowered office and central blood pressure when taken both in the morning and evening hours, and did not have a statistically significant effect on changes in blood circadian pressure.
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References
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