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Azilsartan as a Potent Antihypertensive Drug with Possible Pleiotropic Cardiometabolic Effects: A Review Study
Georgios Georgiopoulos1, Vasiliki Katsi1, Dimitrios Oikonomou1
11st Department of Cardiology, 'Hippokration' Hospital, University of Athens Medical School Athens, Greece.
Insights
Azilsartan medoxomil (AZL-M) effectively lowers blood pressure in diabetic patients with hypertension and shows minimal side effects. Further research is needed to confirm its broader cardiometabolic benefits beyond blood pressure reduction.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Hypertension and metabolic co-morbidities, like type 2 diabetes mellitus (DMII), amplify cardiovascular risks.
- Azilsartan medoxomil (AZL-M), an angiotensin II receptor blocker (ARB), is a key therapeutic option for hypertensive patients with DMII.
Purpose of the Study:
- To systematically review the efficacy, safety, and clinical utility of AZL-M in patients with both hypertension and diabetes mellitus.
- To evaluate the potential cardiometabolic benefits of AZL-M.
Main Methods:
- Systematic literature review of relevant articles.
- Evaluation of clinical efficacy and safety data for AZL-M in hypertensive diabetic patients.
Main Results:
- AZL-M demonstrated superior blood pressure reduction compared to other ARBs and ACE inhibitors, with a favorable safety profile.
- Preclinical studies suggest AZL-M possesses pleiotropic effects, influencing gene expression and cellular pathways relevant to atherosclerosis.
Conclusions:
- Current evidence supports AZL-M's efficacy and safety in diabetic hypertensive patients.
- Clinical data are lacking to confirm AZL-M's benefits in metabolic disorders beyond its antihypertensive action.
- Further clinical studies are necessary to explore the potential pleiotropic cardiometabolic effects of AZL-M.
Background:
Hypertension related cardiovascular (CV) complications could be amplified by the presence of metabolic co-morbidities. Azilsartan medoxomil (AZL-M) is the eighth approved member of angiotensin II receptor blockers (ARBs), a drug class of high priority in the management of hypertensive subjects with diabetes mellitus type II (DMII).
Methods:
Under this prism, we performed a systematic review of the literature for all relevant articles in order to evaluate the efficacy, safety, and possible clinical role of AZL-M in hypertensive diabetic patients.
Results:
AZL-M was found to be more effective in terms of reducing indices of blood pressure over alternative ARBs or angiotensin-converting enzyme (ACE) inhibitors with minimal side effects. Preclinical studies have established pleiotropic effects for AZL-M beyond its primary antihypertensive role through differential gene expression, up-regulation of membrane receptors and favorable effect on selective intracellular biochemical and pro-atherosclerotic pathways.
Conclusion:
Indirect but accumulating evidence from recent literature supports the efficacy and safety of AZL-M among diabetic patients. However, no clinical data exist to date that evince a beneficial role of AZL-M in patients with metabolic disorders on top of its antihypertensive effect. Further clinical studies are warranted to assess the pleiotropic cardiometabolic benefits of AZL-M that are derived from preclinical research.
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