PMID- 26766564
OWN - NLM
STAT- MEDLINE
DCOM- 20161025
LR  - 20181202
IS  - 1473-5598 (Electronic)
IS  - 0263-6352 (Print)
IS  - 0263-6352 (Linking)
VI  - 34
IP  - 4
DP  - 2016 Apr
TI  - Effects of azilsartan medoxomil compared with olmesartan and valsartan on 
      ambulatory and clinic blood pressure in patients with type 2 diabetes and 
      prediabetes.
PG  - 788-97
LID - 10.1097/HJH.0000000000000839 [doi]
AB  - BACKGROUND: Angiotensin receptor blockers (ARBs) are preferred antihypertensive 
      therapies in patients with type 2 diabetes mellitus (T2DM). Azilsartan medoxomil 
      (AZL-M) is a potent ARB for the treatment of stages 1-2 hypertension. We compared 
      the efficacy, safety, and metabolic effects of AZL-M to both valsartan (VAL) and 
      olmesartan (OLM), separately in patients with impaired fasting glucose 
      (prediabetes mellitus) and T2DM. METHODS: A pooled analysis of 3821 patients from 
      three separate randomized placebo-controlled trials comparing the effects of 
      AZL-M (40 and 80 mg), OLM (40 mg), VAL (320 mg), and placebo on changes in 
      ambulatory and clinic blood pressure (BP) among patients with hypertension and 
      prediabetes mellitus or T2DM was performed. Two analysis pools were created to 
      facilitate comparisons: Pool A included patients who received placebo, AZL-M or 
      OLM and Pool B included those who received AZL-M or VAL. Within each pool, 
      patients were stratified by glycemic subgroups (normoglycemic, prediabetes 
      mellitus, or T2DM) based on hemoglobin A1c values. Changes from baseline in both 
      24-h and clinic SBP were the primary efficacy assessments. RESULTS: Baseline 24-h 
      mean SBPs were approximately 145 and 146 mmHg in the prediabetes mellitus and 
      T2DM subgroups, respectively; corresponding clinic SBPs were approximately 158 
      and 159 mmHg. Baseline hemoglobin A1c values for each subgroup (both pools) were 
      normoglycemic, 5.3%; prediabetes mellitus, 6.0%; and T2DM, 6.9%. Changes from 
      baseline in 24-h or clinic SBP were significantly greater with AZL-M, 80 mg 
      compared with either OLM 40 mg or VAL 320 mg in all subgroups in each pool. 
      Safety and tolerability were similar among the active treatment and placebo 
      subgroups. CONCLUSION: These analyses indicate that AZL-M, 80 mg/day lowers SBP 
      by a greater magnitude than OLM or VAL at maximally approved doses in patients 
      with prediabetes mellitus and T2DM. These findings have important clinical 
      implications for this high-risk patient group.
FAU - White, William B
AU  - White WB
AD  - aDivision of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center, 
      University of Connecticut School of Medicine, Farmington, Connecticut bClinical 
      Science, Takeda Development Center, Deerfield cASH Comprehensive Hypertension 
      Center, University of Chicago Medicine, Chicago, Illinois, USA.
FAU - Cuadra, Rene H
AU  - Cuadra RH
FAU - Lloyd, Eric
AU  - Lloyd E
FAU - Bakris, George L
AU  - Bakris GL
FAU - Kupfer, Stuart
AU  - Kupfer S
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - J Hypertens
JT  - Journal of hypertension
JID - 8306882
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Benzimidazoles)
RN  - 0 (Imidazoles)
RN  - 0 (Oxadiazoles)
RN  - 0 (Tetrazoles)
RN  - 80M03YXJ7I (Valsartan)
RN  - 8W1IQP3U10 (olmesartan)
RN  - LL0G25K7I2 (azilsartan medoxomil)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antihypertensive Agents/*pharmacology/therapeutic use
MH  - Benzimidazoles/*pharmacology/therapeutic use
MH  - Blood Pressure/*drug effects
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Humans
MH  - Imidazoles/*pharmacology/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Oxadiazoles/*pharmacology/therapeutic use
MH  - Prediabetic State/*drug therapy
MH  - Tetrazoles/*pharmacology/therapeutic use
MH  - Valsartan/*pharmacology/therapeutic use
PMC - PMC4947533
EDAT- 2016/01/15 06:00
MHDA- 2016/10/26 06:00
PMCR- 2016/07/17
CRDT- 2016/01/15 06:00
PHST- 2016/01/15 06:00 [entrez]
PHST- 2016/01/15 06:00 [pubmed]
PHST- 2016/10/26 06:00 [medline]
PHST- 2016/07/17 00:00 [pmc-release]
AID - 10.1097/HJH.0000000000000839 [doi]
PST - ppublish
SO  - J Hypertens. 2016 Apr;34(4):788-97. doi: 10.1097/HJH.0000000000000839.