Comparative effectiveness of an angiotensin receptor blocker, olmesartan medoxomil, in older hypertensive patients

The efficacy and safety of olmesartan medoxomil (OM) vs active control (AC) monotherapy among elderly patients aged 60‐79 years (N = 4487) was evaluated by meta‐analysis (25 studies). In all patients, change from baseline to end point in blood pressure (BP) was significantly greater with OM vs AC (−19.5/−11.9 vs −16.8/−10.7 mm Hg). Greater proportions of OM‐ vs AC‐treated patients achieved BP goals. In patients with impaired renal function (estimated glomerular filtration rate <60 mL/min/1.73 m2), OM treatment resulted in a greater mean change from baseline in systolic BP vs AC (−21.2 vs −18.7 mm Hg, respectively) and a greater proportion of patients achieving BP goals. These parameters were similar in both groups for elderly patients with diabetes. OM was well tolerated with few adverse events. OM monotherapy can be used as an initial treatment for hypertension in elderly patients, including those with renal impairment or diabetes.

[1]  K. Stylianou,et al.  Renal artery stenting for atherosclerotic renal artery stenosis identified in patients with coronary artery disease: Does captopril renal scintigraphy predict outcomes? , 2018, Journal of clinical hypertension.

[2]  Joseph F. Clark,et al.  Creatine kinase and renal sodium excretion in African and European men on a high sodium diet , 2018, Journal of clinical hypertension.

[3]  T. Fülöp,et al.  Creatine kinase, sodium retention, and blood pressure: Is there a link? , 2018, The Journal of Clinical Hypertension.

[4]  A. Chobanian.  SPRINT Results in Older Patients: How Low to Go? , 2016, JAMA.

[5]  Lenore J Launer,et al.  Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial. , 2016, JAMA.

[6]  Jackson T. Wright,et al.  A Randomized Trial of Intensive versus Standard Blood-Pressure Control. , 2016, The New England journal of medicine.

[7]  Mark D. Huffman,et al.  Heart Disease and Stroke Statistics—2016 Update: A Report From the American Heart Association , 2016, Circulation.

[8]  R. Touyz,et al.  Vascular biology of ageing—Implications in hypertension , 2015, Journal of Molecular and Cellular Cardiology.

[9]  C. Pepine,et al.  Efficacy and safety of angiotensin receptor blockers in older patients: a meta-analysis of randomized trials. , 2015, American journal of hypertension.

[10]  S. Yusuf,et al.  Systolic and Diastolic Blood Pressure Changes in Relation With Myocardial Infarction and Stroke in Patients With Coronary Artery Disease , 2015, Hypertension.

[11]  B. Davis,et al.  Treatment-Resistant Hypertension and the Incidence of Cardiovascular Disease and End-Stage Renal Disease: Results From the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) , 2014, Hypertension.

[12]  Jackson T. Wright,et al.  2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). , 2014, JAMA.

[13]  John Chalmers,et al.  Clinical Practice Guidelines for the Management of Hypertension in the Community , 2014, Journal of clinical hypertension.

[14]  V. Burt,et al.  Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011-2012. , 2013, NCHS data brief.

[15]  Jeroen J. Bax,et al.  2007 ESH-ESC Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). , 2007, Blood pressure.

[16]  J. Izzo,et al.  Olmesartan/amlodipine/hydrochlorothiazide in participants with hypertension and diabetes, chronic kidney disease, or chronic cardiovascular disease: a subanalysis of the multicenter, randomized, double-blind, parallel-group TRINITY study , 2012, Cardiovascular Diabetology.

[17]  A. Lewin,et al.  Efficacy/Safety of Olmesartan Medoxomil Versus Losartan Potassium in Naïve Versus Previously Treated Subjects With Hypertension , 2012, Advances in Therapy.

[18]  Alan S. Brown,et al.  ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. , 2011, Circulation.

[19]  E. Ford.  Trends in Mortality From All Causes and Cardiovascular Disease Among Hypertensive and Nonhypertensive Adults in the United States , 2011, Circulation.

[20]  A. Zanchetti,et al.  Antihypertensive efficacy and safety of olmesartan medoxomil and ramipril in elderly patients with mild to moderate essential hypertension: the ESPORT study , 2010, Journal of hypertension.

[21]  T. Ogihara,et al.  Effects of combination olmesartan medoxomil plus azelnidipine versus monotherapy with either agent on 24-hour ambulatory blood pressure and pulse rate in Japanese patients with essential hypertension: additional results from the REZALT study. , 2010, Clinical therapeutics.

[22]  M. Melino,et al.  Efficacy and tolerability of amlodipine plus olmesartan medoxomil in patients with difficult-to-treat hypertension , 2010, Journal of Human Hypertension.

[23]  T. Ogihara,et al.  A randomized, double-blind, four-arm parallel-group study of the efficacy and safety of azelnidipine and olmesartan medoxomil combination therapy compared with each monotherapy in Japanese patients with essential hypertension: the REZALT study , 2009, Hypertension Research.

[24]  C. Rosendorff,et al.  Comparison of olmesartan medoxomil versus amlodipine besylate on regression of ventricular and vascular hypertrophy. , 2009, The American journal of cardiology.

[25]  J. Mallion,et al.  Olmesartan Medoxomil in Elderly Patients with Essential or Isolated Systolic Hypertension , 2009, Drugs & Aging.

[26]  Li-sheng Liu,et al.  Treatment of hypertension in patients 80 years of age or older. , 2008, The New England journal of medicine.

[27]  M. Melino,et al.  The combination of olmesartan medoxomil and amlodipine besylate in controlling high blood pressure: COACH, a randomized, double-blind, placebo-controlled, 8-week factorial efficacy and safety study. , 2008, Clinical therapeutics.

[28]  J. Mallion,et al.  Systolic blood pressure reduction with olmesartan medoxomil versus nitrendipine in elderly patients with isolated systolic hypertension , 2007, Journal of hypertension.

[29]  S. Oparil,et al.  Comparison of Increasing Doses of Olmesartan Medoxomil, Losartan Potassium, and Valsartan in Patients With Essential Hypertension , 2007, Journal of clinical hypertension.

[30]  K. Reynolds,et al.  Global burden of hypertension: analysis of worldwide data , 2005, The Lancet.

[31]  C. Ram,et al.  Antihypertensive Efficacy of Angiotensin Receptor Blockers in Combination With Hydrochlorothiazide: A Review of the Factorial‐Design Studies , 2004, Journal of clinical hypertension.

[32]  C. V. S. Ram.  Antihypertensive Efficacy of Angiotensin Receptor Blockers in Combination With Hydrochlorothiazide: A Review of the Factorial‐Design Studies , 2004 .

[33]  S. Chrysant,et al.  Evaluation of antihypertensive therapy with the combination of olmesartan medoxomil and hydrochlorothiazide. , 2004, American journal of hypertension.

[34]  Daniel W. Jones,et al.  Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. , 2003, Hypertension.

[35]  S G Chrysant,et al.  Antihypertensive efficacy and safety of olmesartan medoxomil compared with amlodipine for mild-to-moderate hypertension , 2003, Journal of Human Hypertension.

[36]  K. Stumpe,et al.  Antihypertensive efficacy of olmesartan compared with other antihypertensive drugs , 2002, Journal of Human Hypertension.

[37]  S G Chrysant,et al.  Comparative Efficacy of Olmesartan, Losartan, Valsartan, and Irbesartan in the Control of Essential Hypertension , 2001, Journal of clinical hypertension.

[38]  P. Williams,et al.  Relative efficacy of an angiotensin II antagonist compared with other antihypertensive agents. Olmesartan medoxomil versus antihypertensives , 2001, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[39]  C. Escobar Cervantes,et al.  [A randomized trial of intensive versus standard blood pressure control]. , 2016, Semergen.

[40]  A. Schutte,et al.  Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. , 2014, Journal of hypertension.

[41]  Benjamin J. Epstein,et al.  Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure , 2007 .

[42]  A. Januszewicz,et al.  Antihypertensive Efficacy of Olmesartan Medoxomil and Candesartan Cilexetil Assessed by 24-Hour Ambulatory Blood Pressure Monitoring in Patients with Essential Hypertension , 2003, Clinical drug investigation.