Effect of azilsartan versus candesartan on nocturnal blood pressure variation in Japanese patients with essential hypertension

Abstract

Background. Abnormal variations in night-time hypertension such as “non-dipping” type (< 10% decrease in nocturnal systolic blood pressure [SBP] from daytime SBP) are a risk factor for cardiovascular events independent of 24-h BP. Methods. As part of a randomized, double-blind study of azilsartan (20–40 mg once daily) and candesartan (8–12 mg once daily) in Japanese patients with essential hypertension, an exploratory analysis was performed using ambulatory BP monitoring (ABPM) at baseline and Week 14. Effects of study drugs on nocturnal BP variations according to patients’ nocturnal SBP dipping status were evaluated. Results. ABPM data were available for 273 patients treated with azilsartan and 275 with candesartan. In the dipping group (≥ 10% decrease from daytime SBP), azilsartan produced a greater reduction from baseline in daytime than in night-time SBP (− 14.1 and − 10.9 mmHg, respectively), and the change in daytime SBP was significantly greater with azilsartan than with candesartan (p = 0.0077). In the non-dipping group, azilsartan produced a greater reduction from baseline in night-time than in daytime SBP (− 20.2 and − 9.9 mmHg, respectively), and reductions in both night-time SBP (p = 0.02) and daytime SBP (p = 0.0042) were significantly greater with azilsartan than with candesartan. Conclusions. Once-daily azilsartan improved non-dipping night-time SBP to a greater extent than candesartan in Japanese patients with grade I–II essential hypertension.

Key Words::

• Angiotensin receptor blocker
• azilsartan
• candesartan cilexetil
• night-time blood pressure
• nocturnal blood pressure variation

Acknowledgements

The authors would like to thank all patients, physicians and medical staff who supported this study, and ContentEd Net for editorial assistance with the manuscript, which was funded by Takeda Pharmaceutical Company, Limited.

Conflict of interest

HR and KK served as medical experts for this study. HR received honoraria from Takeda Pharmaceutical Company for lectures he gave during the study period. KE, MI and YI are all employees of Takeda Pharmaceutical Company. All authors state that they have no conflicts of interest regarding the content of this article other than those stated above.

Source of funding

The study was sponsored by Takeda Pharmaceutical Company, Limited.