Effect of Azilsartan on Day-to-Day Variability in Home Blood Pressure: A Prospective Multicenter Clinical Trial

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Toru Miyoshi1, Ryoji Suetsuna2, Naoto Tokunaga3

  • 1Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Density and Pharmaceutical Sciences, Okayama, Japan.

Journal of Clinical Medicine Research
|June 15, 2017
PubMed

Insights

Switching to azilsartan medication significantly reduced morning blood pressure variability (BPV) and improved arterial stiffness in patients. This study highlights azilsartan

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Blood pressure variability (BPV), including visit-to-visit, day-by-day, and ambulatory BPV, is a recognized risk factor for cardiovascular events.
  • The impact of antihypertensive therapies on BPV remains incompletely understood.
  • Day-to-day BPV is a critical metric for assessing cardiovascular risk and treatment efficacy.

Purpose of the Study:

  • To investigate the effect of switching from another angiotensin II receptor blocker (ARB) to azilsartan on day-to-day BPV.
  • To evaluate changes in home blood pressure monitoring (HBPM) parameters after initiating azilsartan therapy.
  • To assess the impact of azilsartan on arterial stiffness.

Main Methods:

  • A prospective, multicenter, open-label, single-arm study involving 28 patients treated with an ARB, switched to azilsartan.
  • Primary outcome: Change in the standard deviation and coefficient of variation of morning home BP over 5 consecutive days from baseline to 24 weeks.
  • Secondary outcome: Change in cardio-ankle vascular index (CAVI) as a measure of arterial stiffness.

Main Results:

  • No statistically significant difference in mean morning and evening blood pressure was observed between baseline and 24 weeks.
  • Significant reductions in the standard deviation and coefficient of variation of systolic blood pressure in the morning were noted (P = 0.04).
  • A significant decrease in the cardio-ankle vascular index (CAVI) was observed, indicating improved arterial stiffness (P = 0.03).

Conclusions:

  • Switching from a previous ARB to azilsartan effectively reduced day-to-day blood pressure variability in the morning.
  • Azilsartan therapy demonstrated a positive effect on arterial stiffness, as measured by CAVI.
  • These findings suggest azilsartan may offer benefits beyond blood pressure lowering by improving BPV and vascular health.
Abstract

Keywords:
Arterial stiffnessAzilsartanClinical trialDay to dayVariability

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