腎臓学と治療学ジャーナル

Azilsartan is More Effective as Compared to Olmesartan in Hemodialysis Patients with Uncontrolled Hypertension

Abstract

Akira Ukimura*,Hirohisa Matsuda,Yoko Yamauchi,Kazuhisa Yamamoto,Kei Hirai,Nobuyuki Ueno,Hideaki Yasuda,Shuta Ono

Background: Azilsartan is a new angiotensin receptor blocker with more continuous antihypertensive effects. The objective of this study was to demonstrate the efficacy and safety of azilsartan in hemodialysis patients with uncontrolled hypertension.

Methods: Twenty-two hemodialysis patients treated with multiple antihypertensive drugs including olmesartan (20- 40 mg/day) were enrolled in this retrospective observational study. Blood pressure was measured in the morning and evening for a week at baseline and after switching from olmesartan to azilsartan. The patients’ mean blood pressure at baseline was 171/71 mmHg. Olmesartan (20-40 mg/day) was switched to azilsartan with the same dose. An electrocardiogram, an echocardiogram, and measurement of the ankle-brachial index were performed in all patients, and the echocardiogram showed left ventricular hypertrophy in all patients. Home-measured blood pressure, heart rate, and serum potassium were followed for 9 months after switching.

Results: Systolic blood pressure was significantly decreased at 1, 3, 6, and 9 months after switching. Diastolic blood pressure was significantly decreased at 3 and 6 months after switching. Switching did not alter the serum potassium level.

Conclusions: Switching from olmesartan to azilsartan significantly and safely decreased home-measured blood pressure in hemodialysis patients.