Related Experiment Video
Updated: May 11, 2026

Measuring Ascending Aortic Stiffness In Vivo in Mice Using Ultrasound
Published on: December 2, 2014
Azelnidipine plus olmesartan versus amlodipine plus olmesartan on arterial stiffness and cardiac function in
Takeshi Takami1, Yoshihiko Saito
1Department of Internal Medicine, Clinic Jingumae, Kashihara, Nara, Japan. takami66@m5.kcn.ne.jp
Insights
Olmesartan with azelnidipine improved central blood pressure, left ventricular mass, and arterial stiffness more than olmesartan with amlodipine over two years. These findings highlight azelnidipine
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Hypertension management requires effective strategies to prevent cardiovascular complications.
- Central blood pressure (CBP) and arterial stiffness are key indicators of cardiovascular risk.
- Left ventricular (LV) remodeling and diastolic dysfunction are consequences of uncontrolled hypertension.
Purpose of the Study:
- To compare the long-term effects of olmesartan/azelnidipine versus olmesartan/amlodipine on cardiovascular parameters.
- To evaluate impacts on central blood pressure, LV mass index (LVMI), LV diastolic function, and arterial stiffness.
Main Methods:
- Patients with inadequately controlled hypertension received olmesartan monotherapy.
- Add-on therapy with either azelnidipine or amlodipine was administered for two years.
- Measurements included central blood pressure, LVMI, LV diastolic function indices, and arterial stiffness parameters (baPWV, AIx).
Main Results:
- Both add-on therapies significantly improved brachial and central blood pressure, LVMI, LV diastolic function, and arterial stiffness.
- Olmesartan/azelnidipine demonstrated significantly greater improvements in CBP, LVMI, LV diastolic function (E/A ratio), and arterial stiffness (baPWV, AIx) compared to olmesartan/amlodipine.
- Multivariate analysis indicated independent associations between arterial stiffness, central blood pressure, and LV diastolic function.
Conclusions:
- Olmesartan/azelnidipine offers superior benefits for central hemodynamics, cardiac structure, and vascular health compared to olmesartan/amlodipine in hypertensive patients.
- Improvements in LV diastolic function are linked to concurrent enhancements in arterial stiffness.
- These findings support azelnidipine as a valuable option for add-on therapy in managing resistant hypertension.
Purpose:
To compare the long-term effects of olmesartan combined with either azelnidipine or amlodipine on central blood pressure (CBP), left ventricular (LV) mass index (LVMI), LV diastolic function (e' velocity, E/e' ratio, E/A ratio) and arterial stiffness (brachial-ankle pulse wave velocity [baPWV] and augmentation index normalized for a heart rate of 75 bpm [AIx]).
Patients And Methods:
Patients with systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg received olmesartan monotherapy (20 mg/day) for 12 weeks. They were then randomly assigned to fixed-dose add-on therapy with azelnidipine (16 mg/day; n = 26) or amlodipine (5 mg/day; n = 26) for a further 2 years. CBP, LVMI, e' velocity, E/e' ratio, E/A ratio, baPWV, and AIx were measured at baseline, 6 months, and 2 years.
Results:
Baseline characteristics of both groups were similar. The decrease in brachial BP over 2 years was similar in both groups. CBP, LVMI, E/e' ratio, baPWV, and AIx decreased significantly, and the E/A ratio and e' velocity increased significantly in both groups. The decreases in CBP (P < 0.001), AIx (P < 0.001), baPWV (P < 0.001), LVMI (P < 0.001), and E/e' (P = 0.002) as well as the increase in E/A ratio (P = 0.03) over 2 years were significantly greater in the olmesartan/azelnidipine group than in the olmesartan/amlodipine group. Multivariate linear regression analyses showed that the changes in baPWV (β = 0.41, P < 0.001) and CBP (β = 0.47, P = 0.01) were independently associated with the change in LVMI, the change in baPWV (β = 0.25, P < 0.001) was independently associated with the change in E/e' ratio, and the changes in baPWV (β = 0.21, P = 0.001) and AIx (β = 0.25, P = 0.03) were independently associated with the change in E/A ratio.
Conclusion:
Treatment with olmesartan/azelnidipine for 2 years resulted in greater improvements in CBP, LVMI, and LV diastolic function, and arterial stiffness compared with olmesartan/amlodipine. Improvements in LV diastolic function were associated with improvements in arterial stiffness.
Related Concept Videos
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
Antihypertensive Drugs: Angiotensin II Receptor Blockers
Atherosclerosis III: Management
Hypertension III: Clinical Manifestations and Diagnostic Studies
Antihypertensive Drugs: Vasodilators
Hypertension IV: Drug Therapy and Lifestyle Modifications