Effect of Olmesartan-Based Therapies on Therapeutic Indicators Obtained Through Out-of-Office Blood Pressure

Ambulatory blood pressure (BP) correlates more significantly with hypertension-associated cardiovascular mortality and morbidity than BP obtained in the doctor's office. Assessing ambulatory BP, either through 24-h monitoring or through protocolized self-measurement at home, is essential in diagnosing and monitoring patients with hypertension. Several ambulatory BP-derived indicators are related with cardiovascular prognosis. These include 24-h, daytime and nighttime BP measurements, BP measurements obtained through home self-measurement, dipping status, morning surge, and BP variability. The objective of this article was to review the effect of olmesartan-based antihypertensive therapy on the main risk variables obtained when assessing ambulatory BP.

Daytime systolic ambulatory blood pressure with a two-step switch from candesartan to olmesartan monotherapy and the fixed-dose combination of olmesartan/amlodipine in patients with uncontrolled essential hypertension (SEVICONTROL-2)

The objective of this study was to investigate the efficacy of the fixed-dose combination olmesartan/amlodipine 40/10 mg in patients with moderate essential hypertension not controlled on candesartan 32 mg. This was a prospective, single-arm, phase IV study. The primary endpoint was the change in mean daytime systolic blood pressure (BP). A total of 77 of 89 screened patients started candesartan 32 mg, 62 olmesartan 40 mg, and 57 olmesartan 40 mg/amlodipine 10 mg. Mean daytime systolic BP was reduced by 9.8±15.2 mm Hg (P<.001) vs candesartan monotherapy. Office BP reduction was 9.2±18.8/5.0±8.9 mm Hg (P<0.001). Treatment goals (<140/90 mm Hg for office and <135/85 mm Hg for ambulatory BP) were achieved in 58.2% and 78.4% of patients, respectively. There was one drug-related adverse event (edema) and no serious adverse events. Patients of Caucasian ethnicity with moderate essential hypertension uncontrolled on candesartan experienced a further drop in BP using olmesartan and amlodipine.