Efficacy of angiotensin receptor blockers for nocturnal blood pressure reduction: a systematic review and meta-analysis

Figures & data

Figure 1. PRISMA diagram of the literature selection.

Table 1. The basic characteristics of included studies.

Study ID	Study design	Sample size	Age (Mean ± SD)	BMI (Kg/m^2) (Mean ± SD)	ADBP (mmHg) (Mean ± SD)	ASBP (mmHg) (Mean ± SD)	Drug	Dose/frequency	Follow-up	Outcome
Pechère-Bertschi 1998 [14]	RCT^a	20	NR	NR	NR	NR	Irbesartan	100 mg, qd	6 weeks	②③
White 2005 [15]	Before and after study	1619	55.8 ± 13.3	30 ± 6	NR	NR	Telmisartan	40-80 mg, qd	6-10 weeks	②③④
BAGUET 2006 [16]	RCT	87	54 ± 11	NR	91 ± 10	140 ± 14	Candesartan	8 mg, qd	6 weeks	①②③④
		89	54 ± 11	NR	89 ± 9	140 ± 16	Losartan	50 mg, qd	6 weeks
Bai 2002 [17]	Before and after study	20	49.5 ± 7.4	NR	90.6 ± 7.0	137.8 ± 15.4	Telmisartan	40 mg, qd	6 weeks	①②③
Brunner 2003 [18]	RCT	319	51.5 ± 10.5	28.3 ± 4.4	92.33 ± 4.90	145.69 ± 11.00	Olmesartan	20 mg, qd	1/2/8 weeks	①②③
		324	51.8 ± 9.8	28.9 ± 4.2	92.17 ± 4.86	146.25 ± 10.72	Candesartan	8 mg, qd	1/2/8 weeks
Cai 2002 [19]	RCT	59	50 ± 7	NR	NR	NR	Losartan	50-100 mg, qd	2/4/6/8 weeks	①②③
		58	52 ± 6	NR	NR	NR	Irbesartan	75-150 mg, qd	2/4/6/8 weeks
Cao 2001 [20]	RCT^a	21	48.09	NR	93.6 ± 6.5	142.3 ± 10.2	Losartan	50 mg, qd	4 weeks	①②③
Chen 2004 [21]	Before and after study	60	52 ± 6	NR	89.26 ± 7.5	137.26 ± 12.75	Irbesartan	150 mg, qd	4 weeks	①②③
Cheung 2017 [22]	RCT	188	57.1 ± 10.19	30.5 ± 5.86	81.6 ± 11.94	139.0 ± 15.53	Sacubitril Valsartan	200 mg, qd	12 weeks	①②③
		187	58.0 ± 9.09	30.6 ± 5.09	82.5 ± 9.29	139.3 ± 12.98	Olmesartan	20 mg, qd	12 weeks
Chrysant 2003 [23]	RCT^a	188	51.7	NR	95.5	153.9	Olmesartan	20 mg, qd	8 weeks	①②③
Chung 2000 [24]	RCT^a	132	NR	NR	90.22 ± 6.11	148.36 ± 12.02	Losartan	50-100 mg, qd	12 weeks	①②③
Chung 2020 [25]	RCT	157	58.99 ± 7.06	25.38 ± 2.80	91.18 ± 8.11	149.97 ± 12.77	Valsartan	80-160 mg, qd	6 weeks	①②③
		53	57.55 ± 8.21	25.74 ± 2.69	91.99 ± 8.23	151.36 ± 14.40	Olmesartan	10-20 mg, qd	6 weeks
Coca 2001 [26]	RCT^a	115	52.7 ± 10.0	29.3 ± 4.0	89.9 ± 6.2	144.2 ± 11.5	Irbesartan	150 mg, qd	12 weeks	①②③
Dusing 2012 [27]	RCT^a	408	56.0 ± 11.91	29.15 ± 5.127	88.3 ± 9.53	146.9 ± 9.52	Telmisartan	40-80 mg, qd	12 weeks	①②③④
Fan 2002 [28]	RCT^a	35	NR	NR	92.1 ± 6.8	150.8 ± 10.3	Valsartan	160 mg, qd	12 weeks	①②③
Fang 2003 [29]	RCT^a	9	NR	NR	85.1 ± 9.0	135.8 ± 14.0	Losartan	50 mg, qd	8 weeks	①②③
Fogari 2006 [30]	RCT	57	59.3 ± 11.3	NR	90.0 ± 4.5	152.5 ± 9.8	Olmesartan	20 mg, qd	4/8 weeks	①②③
		56	59.9 ± 11.5	NR	90.2 ± 3.9	152.6 ± 10.4	Valsartan	160 mg, qd	4/8 weeks
Fogari 2008 [31]	RCT	63	60.1 ± 10.9	25.6 ± 0.5	90.9 ± 6.1	153.1 ± 10.3	Olmesartan	20 mg, qd	8/16 weeks	①②③
		63	59.9 ± 11.5	25.4 ± 0.4	91.5 ± 6.4	152.9 ± 9.9	Telmisartan	80 mg, qd	8/16 weeks
Gao 2014 [32]	RCT^a	45	57.53 ± 7.48	26.34 ± 0.92	92.93 ± 1.70	152.16 ± 6.79	Telmisartan	40-80 mg, qd	8 weeks	①②③⑤
Germino 2012 [33]	RCT	60	71.7 ± 5.6	NR	78.9 ± 6.9	142.7 ± 7.4	Olmesartan	20 mg, qd	12 weeks	①②③④
		116	72.0 ± 5.0	NR	82.0 ± 9.0	152.0 ± 11.1	Olmesartan	20 mg, qd	12 weeks
Giles 2012 [34]	RCT	68	54.6 ± 10.2	30.6 ± 6.8	88.8 ± 8.5	141.6 ± 11.7	Valsartan	160-320 mg, qd	8 weeks	①②③④⑤
		72	54.3 ± 9.4	29.9 ± 5.5	92.8 ± 8.5	146.8 ± 13.0	Valsartan	160-320 mg, qd	8 weeks
Guo 2002 [35]	RCT	20	53 ± 9	NR	90.01 ± 5.25	141.01 ± 16.5	Irbesartan	150-300 mg, qd	8 weeks	①②③
Guo 2003 [36]	RCT^a	12	Not new cases:51 ± 8 New cases:49 ± 10	Not new cases:24.6 ± 2.5 New cases:49 ± 10	87.76 ± 8.25	132.76 ± 9.75	Losartan	50 mg, qd	8 weeks	①②③
Hermida 2005a [37]	RCT^a	72	53.1 ± 12.1	28.7 ± 4.7	84.5 ± 8.6	137.7 ± 10.7	Valsartan	160 mg, qd	3 months	①③⑤
Hermida 2005b [38]	RCT^a	102	50.5 ± 13.2	28.8 ± 4.3	86.0 ± 7.6	137.9 ± 11.5	Valsartan	160 mg, qd	3 months	②③⑥
Hermida 2005c [39]	RCT^a	50	68.3 ± 4.7	30.0 ± 4.9	77.7 ± 7.8	139.6 ± 10.2	Valsartan	160 mg, qd	3 months	①②③⑥
Hermida 2007 [40]	RCT^a	107	46.4 ± 11.5	27.1 ± 4.2	84.8 ± 7.4	132.6 ± 10.0	Telmisartan	80 mg, qd	NR	①②③⑥
Hermida 2009 [41] [NCT00295542]	RCT^a	67	45.5 ± 11.9	28.8 ± 5.0	82.2 ± 5.8	129.5 ± 8.7	Olmesartan	20 mg, qd	3 months	①②③⑥
Houlihan 2002 [42]	RCT^a	10	60.6 ± 3.7	30.4 ± 2.1	NR	NR	Losartan	50 mg, qd	12 weeks	①③
Hu 2009 [43]	RCT	32	51 ± 9	NR	92 ± 1	141 ± 2	Olmesartan	20-40 mg, qd	8 weeks	①②③
Hua 2007 [44]	RCT	28	NR	NR	NR	NR	Losartan	50 mg, qd	8 weeks	①②③
		30	NR	NR	NR	NR	Valsartan	80 mg, qd	8 weeks
		21	NR	NR	NR	NR	Candesartan	8 mg, qd	8 weeks
		25	NR	NR	NR	NR	Irbesartan	150 mg, qd	8 weeks
		20	NR	NR	NR	NR	Olmesartan	20 mg, qd	8 weeks
Huang 1999 [45]	RCT^a	24	NR	NR	NR	NR	Losartan	50-100 mg, qd	8 weeks	①②③
Huang 2012 [46]	RCT^a	40	49.2 ± 8.5	25.8 ± 3.1	97.6 ± 8.6	149.6 ± 15.5	Losartan	50-100 mg, qd	12 weeks	②③
Huo 2019 [47]	RCT	479	57.5 ± 10.17	26.4 ± 3.91	86.3 ± 9.40	143.2 ± 11.93	Sacubitril Valsartan	200 mg, qd	8 weeks	①②③
		484	57.4 ± 10.14	26.4 ± 3.92	86.7 ± 9.52	141.4 ± 11.84	Olmesartan	20 mg, qd	8 weeks
Izzo 2016 [48]	Before and after study	362	51.8 ± 9.7	30.5 ± 5.9	89.5 ± 8.5	141.2 ± 12.2	Valsartan	160-320 mg, qd	4/8/12 weeks	①②③④
Kuschnir 2004 [49]	RCT^a	100	56	NR	95.0 ± 9.3	152.3 ± 15.7	Losartan	50 mg, qd	4/8 weeks	①②③
Lacourcière 1999 [50]	RCT	116	55	28	NR	NR	Candesartan	8 − 16 mg, qd	4/8 weeks	①②③
		115	55	29/28 [male/female]	NR	NR	Losartan	50-100 mg, qd	4/8 weeks
Lacourcière 2000 [51]	RCT^a	52	59.2 ± 9.2	NR	89.7 [ABP: 38]	158.4 [ABP: 38]	Losartan	50-100 mg, qd	12/28/52 weeks	①②③
Lacourcière 2004 [52]	RCT	468	53.7 ± 10.0	28.8 ± 4.7	93.4 ± 6.2	149.1 ± 11.8	Telmisartan	40-80 mg, qd	8 weeks	①②③④
		462	54.1 ± 9.7	29.1 ± 4.7	92.9 ± 5.9	149.1 ± 12.0	Valsartan	80-160 mg, qd	8 weeks
Lee 2013 [53]	RCT^a	32	56 ± 7.2	25.2 ± 2.9	NR	NR	Valsartan	80 mg, qd	8 weeks	①②③
Lee 2017 [54]	RCT^a	30	57 ± 7.4	24.07 ± 2.66	89.7 ± 5.5	146.2 ± 9.2	Valsartan	80 mg, qd	8 weeks	①②③
Leonetti 2006 [55]	RCT^a	122	51 ± 9	NR	84.1 ± 8.2 [ABP: 59]	132.9 ± 11.2 [ABP: 59]	Candesartan	8 mg, qd	12 weeks	①②③④
Li 2014a [56]	RCT	24	49.8 ± 10.9	25.2 ± 2.9	90 ± 11	135 ± 12	Olmesartan	20 mg, qd	8 weeks	①②③
		24	50.3 ± 9.6	24.9 ± 2.5	89 ± 11	133 ± 15	Olmesartan Medoxomil	20 mg, qd	8 weeks
Li 2014b [57]	RCT	24	62.24 ± 7.88	NR	90 ± 11	135 ± 13	Olmesartan	20-40 mg, qd	8 weeks	①②③
		24	64.12 ± 6.74	NR	88 ± 11	133 ± 15	Olmesartan Medoxomil	20-40 mg, qd	8 weeks
Lian 2011 [58]	RCT^a	48	50.52 ± 8.53	27.52 ± 3.84	NR	NR	Irbesartan	150 mg, qd	4 weeks	①②③
Mai 2000 [59]	RCT^a	30	53.8 ± 8.2	NR	93.2 ± 6.5	153.4 ± 6.7	Losartan	50-100 mg, qd	6 weeks	①②③
Malacco 2000 [60]	RCT	40	51 ± 7	NR	91.7 ± 4.8	144.9 ± 6.9	Valsartan	80 mg, qd	4 weeks	①②③
		40	51 ± 7	NR	91.7 ± 4.8	144.9 ± 6.9	Irbesartan	150 mg, qd	4 weeks
Malacco 2010 [61]	RCT^a	542	72 ± 5	26 ± 3	80.9 ± 9.2	141.2 ± 13.9	Olmesartan	10-40 mg, qd	12 weeks	①②③④
Mallion 1999 [62]	RCT	57	56	29.1	91.2 ± 5.8	148.0 ± 12.0	Losartan	50 mg, qd	6 weeks	①②③④
		57	58	28.5	94.0 ± 5.8	151.5 ± 12.6	Telmisartan	40 mg, qd	6 weeks
		54	57	29.3	94.0 ± 6.4	151.2 ± 11.8	Telmisartan	80 mg, qd	6 weeks
Malllion 2011 [63]	RCT^a	170	72 ± 5	NR	82 ± 14	144 ± 20	Olmesartan	10-40 mg, qd	12 weeks	①④
Mancia 2002 [64]	RCT	215	55.4 ± 9.9	NR	89.1 ± 8.3	143.8 ± 12.0	Valsartan	80 mg, qd	8 weeks	①②③
		211	55.1 ± 9.7	NR	88.2 ± 8.3	142.2 ± 12.7	Irbesartan	150 mg, qd	8 weeks
Manzur 2018 [65]	RCT^a	23	47.8 ± 12.0	28.8 ± 4.3	81.3 ± 6.1	127.5 ± 6.5	Valsartan	80-160 mg, qd	6/12 weeks	①②③
Matsumoto 2009 [66]	RCT^a	18	60.8 ± 10.2	NR	92.1 ± 7.8	146.9 ± 8.7	Olmesartan	10-20 mg, qd	4/8 weeks	①②③
Moltzer 2010 [67]	RCT^a	16	NR	NR	77.3 ± 2.2	141.7 ± 2.0	Candesartan	8 mg, qd	8 weeks	①②③
Munakata 2004 [68]	RCT^a	21	53 ± 3	24.8 ± 3.3	90 ± 2.5	148 ± 2.5	Valsartan	80 mg, qd	12 weeks	①②③
Neutel 1997 [69]	RCT	44	55.0 ± 10.3	NR	92.3 ± 9.0	150.6 ± 13.6	Valsartan	20 mg, qd	8 weeks	②③
		44	53.6 ± 10.4	NR	89.6 ± 9.2	148.0 ± 16.2	Valsartan	80 mg, qd	8 weeks
		41	53.2 ± 9.7	NR	91.2 ± 8.8	146.7 ± 13.3	Valsartan	160 mg, qd	8 weeks
		45	54.7 ± 11.0	NR	90.7 ± 9.8	148.4 ± 13.7	Valsartan	320 mg, qd	8 weeks
Neutel 2003 [70]	RCT^a	351	54.2 ± 10.6	28.4 ± 4.5	93.2 ± 6.7	150.1 ± 14.1	Telmisartan	80 mg, qd	6 weeks	①②③④
Palatini 2002 [71]	RCT^a	133	51.9 ± 9.4	NR	88.3 ± 7.6	141.4 ± 11.4	Valsartan	80 mg, qd	12 weeks	①②③
Palatini 2010 [72]	RCT^a	222	53.4 ± 9.7	29 ± 4.6	93 ± 6.4	145.4 ± 12.1	Irbesartan	150-300 mg, qd	6 weeks	①②③
Pereze 2016 [73]	RCT^a	63	53.4 ± 11	29.3 ± 5.5	88.4 ± 10.5	141.3 ± 13.8	Olmesartan	20 mg, qd	8 weeks	①②③
Qian 2005 [74]	RCT	120	50 ± 9	25 ± 3	89.26 ± 6	139.51 ± 16.5	Candesartan	8-16 mg, qd	8 weeks	①②③
		120	51 ± 8	25 ± 3	84.01 ± 6.75	134.26 ± 11.25	Losartan	50-100 mg, qd	8 weeks
Qin 2000 [75]	RCT^a	30	NR	NR	NR	NR	Losartan	50-100 mg, qd	4 weeks	①②③
Ribeiro 2007 [76]	RCT^a	97	55.4 ± 10.3	27.4 ± 4.0	90.4 ± 8.8 [ABP: 92]	143.1 ± 18.2 [ABP: 92)	Losartan	50-100 mg, qd	12 weeks	①②③④
Smolensky 2007 [77]	Before and after study	18	51.6	25.5 ± 2.9	NR	NR	Olmesartan	20 mg, qd	12 weeks	①②③
Stanton 2003 [78]	RCT^a	36	55.9 ± 8.9	28.0 ± 4.5	NR	NR	Losartan	100 mg, qd	4 weeks	①
Sun 2010 [Sun NL 2010, unpublished data]	RCT	337	53.40 ± 9.327	25.53 ± 2.466	NR	NR	Losartan	50 mg, qd	12 weeks	①②③
		344	54.6 ± 8.963	25.57 ± 2.584	95.2 ± 6.4	145.0 ± 8.2	Allisartan	240 mg, qd	12 weeks
Sun 2017 [79]	Before and after study	195	52.9 ± 10.2	25.6 ± 3.3	88 ± 10	136.3 ± 11.8	Valsartan	80-160 mg, qd	2/10 weeks	①②③④⑤
Tong 2013 [80]	RCT^a	113	51.97 ± 8.67	NR	NR	NR	Irbesartan	150 mg, qd	4 weeks	①②③
Wang 2004 [81]	Before and after study	37	NR	NR	90.73 ± 7.3	138.73 ± 14.16	Candesartan	8 mg, qd	8 weeks	①②③
Wang 2006 [82]	RCT^a	21	NR	NR	91.44 ± 5.53	142.39 ± 7.15	Candesartan	8 mg, qd	8 weeks	①②③
Wang 2011 [83]	RCT^a	50	47.4 ± 12.0	NR	84.6 ± 7.2	132.5 ± 10.1	Telmisartan	80 mg, qd	12 weeks	②③⑤
Wang 2015 [84]	RCT^a	42	68.13 ± 6.75	26.69 ± 1.54	91.82 ± 1.68	151.05 ± 5.68	Telmisartan	40-80 mg, qd	8 weeks	①②③⑤
Wang 2022 [85]	Before and after study	48	55.69 ± 12.90	25.40 ± 2.59	80.46 ± 10.19	133.29 ± 11.56	Allisartan	240 mg, qd	12 weeks	①②③④
Williams 2009 [86]	RCT^a	802	53.3 ± 10.4	29.6 ± 5.1	92.6 ± 6.4	147.9 ± 12.3	Telmisartan	80 mg, qd	8/14 weeks	①②③④
Wu 2011 [87]	RCT^a	40	57.10 ± 8.7	27.00 ± 1.20	92.4 ± 4.1	147.3 ± 6.6	Telmisartan	80 mg, qd	12 weeks	②③⑥
Kawano 2008 [88]	RCT^a	38	58.9 ± 8.3	66.5 ± 13.4	95.0 ± 8.8	145.0 ± 10.9	Irbesartan	100 mg, qd	6 weeks	②③
Tanigawara 2009 [89]	RCT^a	30	54.4 ± 7.3	NR	96.8 ± 5.8	156.8 ± 10	Olmesartan	10-20 mg, qd	8 weeks	①②③

Abbreviations: ABP: ambulatory blood pressure; ADBP: 24 h ambulatory diastolic blood pressure; ASBPL: 24 h ambulatory systolic blood pressure; BMI: body mass index; NR: not reported; qd: once a day; RCT: randomized controlled trial; SD: standard deviation.

^a One arm from the RCT was included in analysis.

① 24h ambulatory blood pressure drop; ② daytime ambulatory blood pressure drop; ③ nocturnal ambulatory blood pressure drop; ④ last 4-6 h ambulatory blood pressure drop; ⑤ The proportion of dipper blood pressure.

Figure 2. Nocturnal ambulatory blood pressure drops (Fifty-two studies with 7190 patients).

Figure 3. Nocturnal-diurnal blood pressure drop ratio (Forty-four studies with 4694 patients).

Figure 4. Last 4-6 h ambulatory blood pressure drops (Nine studies with 2412 patients).

Figure 5. The proportion of patients exhibiting a dipper pattern of BP variation (Six studies with 595 patients).

Pechère-Bertschi A, Nussberger J, Decosterd L, et al. Renal response to the angiotensin II receptor subtype 1 antagonist irbesartan versus enalapril in hypertensive patients. J Hypertens. 1998;16(3):385–393. doi:10.1097/00004872-199816030-00016.

 PubMed Web of Science ®Google Scholar

White WB, Weber MA, Davidai G, et al. Ambulatory blood pressure monitoring in the primary care setting: assessment of therapy on the circadian variation of blood pressure from the MICCAT-2 trial. Blood Press Monit. 2005;10(3):157–163. doi:10.1097/00126097-200506000-00008.

 PubMed Web of Science ®Google Scholar

Baguet JP, Nisse-Durgeat S, Mouret S, et al. A placebo-controlled comparison of the efficacy and tolerability of candesartan cilexetil, 8 mg, and losartan, 50 mg, as monotherapy in patients with essential hypertension, using 36-h ambulatory blood pressure monitoring. Int J Clin Pract. 2006;60(4):391–398. doi:10.1111/j.1368-5031.2006.00903.x.

 PubMed Web of Science ®Google Scholar

Bai J, Zhu JR, Cai S, et al. Clinical efficacy and safety of telmisartan in patients with mild to moderatehypertension: a multi-center randomized controlled clinical trial. Chin J Cardiol. 2002;30:738–742. doi:10.3760/j:issn:0253-3758.2002.12.008.

 Google Scholar

Brunner HR, Stumpe KO, Januszewicz A. Antihypertensive efficacy of olmesartan medoxomil and candesartan cilexetil assessed by 24-hour ambulatory blood pressure monitoring in patients with essential hypertension. Clin Drug Investig. 2003;23(7):419–430. doi:10.2165/00044011-200323070-00001.

 PubMed Web of Science ®Google Scholar

Cai SY, Zhang XH, Hu XS, et al. Irbesartan in treatment of mild to moderate essential hypertension. Chin J New Drugs Clin Rem. 2002;21:277–280. doi:10.3969/j.issn.1007-7669.2002.05.007.

 Google Scholar

Cao YA, Peng CS, Long NZ, et al. The clinical observation of combined treatment with losartan potassium and indapamide for essential hypertension. Prog Mater Sci. 2001;25:303–307. doi:10.3969/j.issn.1001-5094.2001.05.012.

 Google Scholar

Chen SX, Guo YZ, Wu ST, et al. Antihypertensive effects of irbesartan single and combined treatments on 60 patients with mild to moderate essential hypertension. Chin J New Drugs Clin Rem. 2004;23:651–654. doi:10.3969/j.issn.1007-7669.2004.10.001.

 Google Scholar

Cheung DG, Aizenberg D, Gorbunov V, et al. Efficacy and safety of sacubitril/valsartan in patients with essential hypertension uncontrolled by olmesartan: a randomized, double-blind, 8-week study. J Clin Hypertens. 2018;20(1):150–158. doi:10.1111/jch.13153.

 PubMed Web of Science ®Google Scholar

Chrysant SG, Marbury TC, Robinson TD. Antihypertensive efficacy and safety of olmesartan medoxomil compared with amlodipine for mild-to-moderate hypertension. J Hum Hypertens. 2003;17(6):425–432. doi:10.1038/sj.jhh.1001577.

 PubMed Web of Science ®Google Scholar

Chung O, Hinder M, Sharma AM, et al. Comparison of the efficacy and safety of losartan (50-100 mg) with the T-type calcium channel blocker mibefradil (50-100 mg) in mild to moderate hypertension. Fund Clin Pharmacol. 2000;14:31–41. doi:10.1111/j.1472-8206.2000.tb00391.x.

 PubMed Web of Science ®Google Scholar

Chung WB, Ihm SH, Jang SW, et al. Effect of fimasartan versus valsartan and olmesartan on office and ambulatory blood pressure in korean patients with mild-to-moderate essential hypertension: a randomized, double-blind, active control, three-parallel group, forced titration, multicenter, phase IV study (fimasartan achieving systolic blood pressure target (FAST) study). Drug Des Devel Ther. 2020;14:347–360. doi:10.2147/DDDT.S231293.

 PubMed Web of Science ®Google Scholar

Coca A, Calvo C, García-Puig J, et al. A multicenter, randomized, double-blind comparison of the efficacy and safety of irbesartan and enalapril in adults with mild to moderate essential hypertension, as assessed by ambulatory blood pressure monitoring: the MAPAVEL study (monitorización ambulatoria presión arterial APROVEL). Clin Ther. 2002;24(1):126–138. doi:10.1016/s0149-2918(02)85010-x.

 PubMed Web of Science ®Google Scholar

Düsing R, Brunel P, Baek I, et al. Sustained decrease in blood pressure following missed doses of aliskiren or telmisartan: the ASSERTIVE double-blind, randomized study. J Hypertens. 2012;30(5):1029–1040. doi:10.1097/HJH.0b013e328351c263.

 PubMed Web of Science ®Google Scholar

Fan YM, Zeng QY, Mai WY, et al. Clinical study on treating mild to moderate essential hypertension with combination of AT1 antagonist and ACEI. Front Cardiovasc Med. 2002;02:112–115. doi:10.3969/j.issn.1673-6583.2002.02.017.

 Google Scholar

Fang GQ, Zhang LT, Chen YH, et al. Efficacy and safety evaluation of levamlodipine in the treatment of primary mild to moderate hypertension. Clin Med Chin. 2003;19:36–37. doi:10.3760/cma.j.issn.1008-6315.2003.10.019.

 Google Scholar

Fogari R, Zoppi A, Mugellini A, et al. Hydrochlorothiazide added to valsartan is more effective than when added to olmesartan in reducing blood pressure in moderately hypertensive patients inadequately controlled by monotherapy. Adv Ther. 2006;23(5):680–695. doi:10.1007/BF02850307.

 PubMed Web of Science ®Google Scholar

Fogari R, Zoppi A, Mugellini A, et al. Effectiveness of hydrochlorothiazide in combination with telmisartan and olmesartan in adults with moderate hypertension not controlled with monotherapy: a prospective, randomized, open-label, blinded end point (PROBE), parallel-arm study. Curr Ther Res Clin Exp. 2008;69(1):1–15. doi:10.1016/j.curtheres.2008.02.003.

 PubMed Web of Science ®Google Scholar

Gao CY, Chen LM, Ying JQ, et al. Efficacy of combination of three drugs (telmisartan, hydrochlorothiazide, levo-amlodipine) in small doses on Middle-aged and elderly non-dipper hypertension. Chin J Biochem Pharm. 2014;34:143–145.

 Google Scholar

Germino FW, Neutel JM, Dubiel R, et al. Efficacy of olmesartan medoxomil and hydrochlorothiazide fixed-dose combination therapy in patients aged 65 years and older with stage 1 and 2 hypertension or isolated systolic hypertension. Am J Cardiovasc Drugs. 2012;12(5):325–333. doi:10.1007/BF03261841.

 PubMed Web of Science ®Google Scholar

Giles TD, Alessi T, Purkayastha D, et al. Comparative efficacy of aliskiren/valsartan vs valsartan in nocturnal dipper and non-dipper hypertensive patients: a pooled analysis. J Clin Hypertens (Greenwich). 2012;14(5):299–306. doi:10.1111/j.1751-7176.2012.00608.x.

 PubMed Web of Science ®Google Scholar

Guo YZ, Qian YS, Ma AQ, et al. Efficacy and safety of irbesartan in treating essential hypertension. Chin J New Drugs Clin Rem. 2002;11:645–648. doi:10.3969/j.issn.1007-7669.2002.11.002.

 Google Scholar

Guo YZ, Qian YS, Tao B, et al. Comparison of efficacy and safety of levoamlodipine besylate and losartanin treating 140 patients with essential hypertension. Chin J New Drugs Clin Rem. 2003;22:766–769. doi:10.3969/j.issn.1007-7669.2003.12.008.

 Google Scholar

Hermida RC, Calvo C, Ayala DE, et al. Treatment of non-dipper hypertension with bedtime administration of valsartan. J Hypertens. 2005;23(10):1913–1922. doi:10.1097/01.hjh.0000182522.21569.c5.

 PubMed Web of Science ®Google Scholar

Hermida RC, Calvo C, Ayala DE, et al. Decrease in urinary albumin excretion associated with the normalization of nocturnal blood pressure in hypertensive subjects. Hypertension. 2005;46(4):960–968. doi:10.1161/01.HYP.0000174616.36290.fa.

 PubMed Web of Science ®Google Scholar

Hermida RC, Calvo C, Ayala DE, et al. Administration time-dependent effects of valsartan on ambulatory blood pressure in elderly hypertensive subjects. Chronobiol Int. 2005;22(4):755–776. doi:10.1080/07420520500180488.

 PubMed Web of Science ®Google Scholar

Hermida RC, Ayala DE, Fernández JR, et al. Comparison of the efficacy of morning versus evening administration of telmisartan in essential hypertension. Hypertension. 2007;50(4):715–722. doi:10.1161/HYPERTENSIONAHA.107.094235.

 PubMed Web of Science ®Google Scholar

Hermida RC, Ayala DE, Chayan L, et al. Administration-time-dependent effects of olmesartan on the ambulatory blood pressure of essential hypertension patients. Chronobiol Int. 2009;26(1):61–79. doi:10.1080/07420520802548135.

 PubMed Web of Science ®Google Scholar

Houlihan CA, Allen TJ, Baxter AL, et al. A low-sodium diet potentiates the effects of losartan in type 2 diabetes. Diabetes Care. 2002;25(4):663–671. doi:10.2337/diacare.25.4.663.

 PubMed Web of Science ®Google Scholar

Hu YR, Chen SX, Zhang J, et al. Efficacy and safety of domestic olmesartan in treatment of mild to moderate essential hypertension. J Shanghai Jiaotong Univ. 2009;29:1359–1362.

 Google Scholar

Hua CX, Hua L, Li N, et al. Efficacy of monotherapy with 15 antihypertensive agents in treating essential hypertension assessed by 24-hour ambulatory blood pressure monitoring. Acta Acad Med Sin. 2007;06:792–796.

 Google Scholar

Huang J, Guo JZ, Tao P, et al. Efficacy and safety evaluation of losartan in the treatment of mild and moderate hypertension. Chin J Cardiol. 1999;27:36–39. doi:10.3760/j:issn:0253-3758.1999.03.010.

 Google Scholar

Huang RJ, Guo YB, Zheng YX. The effect of eplerenone and losartan on arterial stiffness and centraarterial pressure in patients with mild to moderate essential hypertension. Chin J Hyperten. 2012;20:776–780. doi:10.16439/j.cnki.1673-7245.2012.08.021.

 Google Scholar

Huo Y, Li W, Webb R, et al. Efficacy and safety of sacubitril/valsartan compared with olmesartan in asian patients with essential hypertension: a randomized, double-blind, 8-week study. J Clin Hypertens (Greenwich). 2019;21(1):67–76. doi:10.1111/jch.13437.

 PubMed Web of Science ®Google Scholar

Izzo JL, Jr, Jia Y, Zappe DH. Influence of age and race on 24-hour ambulatory blood pressure responses to valsartan, hydrochlorothiazide, and their combination: implications for clinical practice. J Clin Hypertens. 2017;19(2):143–150. doi:10.1111/jch.12891.

 Web of Science ®Google Scholar

Kuschnir E, Bendersky M, Resk J, et al. Effects of the combination of low-dose nifedipine GITS 20 mg and losartan 50 mg in patients with mild to moderate hypertension. J Cardiovasc Pharmacol. 2004;43(2):300–305. doi:10.1097/00005344-200402000-00021.

 PubMed Web of Science ®Google Scholar

Lacourcière Y, Asmar R. A comparison of the efficacy and duration of action of candesartan cilexetil and losartan as assessed by clinic and ambulatory blood pressure after a missed dose, in truly hypertensive patients: a placebo-controlled, forced titration study. Candesartan/losartan study investigators. Am J Hypertens. 1999;12(12 Pt 1-2):1181–1187. doi:10.1016/s0895-7061(99)00142-9.

 PubMed Web of Science ®Google Scholar

Lacourcière Y, Bélanger A, Godin C, et al. Long-term comparison of losartan and enalapril on kidney function in hypertensive type 2 diabetics with early nephropathy. Kidney Int. 2000;58(2):762–769. doi:10.1046/j.1523-1755.2000.00224.x.

 PubMed Web of Science ®Google Scholar

Lacourcière Y, Krzesinski JM, White WB, et al. Sustained antihypertensive activity of telmisartan compared with valsartan. Blood Press Monit. 2004;9(4):203–210. doi:10.1097/00126097-200408000-00005.

 PubMed Web of Science ®Google Scholar

Lee H, Kim KS, Chae SC, et al. Ambulatory blood pressure response to once-daily fimasartan: an 8-week, multicenter, randomized, double-blind, active-comparator, parallel-group study in korean patients with mild to moderate essential hypertension. Clin Ther. 2013;35(9):1337–1349. doi:10.1016/j.clinthera.2013.06.021.

 PubMed Web of Science ®Google Scholar

Lee HY, Kim CH, Song JK, et al. 24-Hour blood pressure response to lower dose (30 mg) fimasartan in korean patients with mild to moderate essential hypertension. Korean J Intern Med. 2017;32(6):1025–1036. doi:10.3904/kjim.2016.094.

 PubMed Web of Science ®Google Scholar

Leonetti, G., Rappelli, A., Omboni, S., on Behalf of the Study Group, on Behalf of the Study Group. A similar 24-h blood pressure control is obtained by zofenopril and candesartan in primary hypertensive patients. Blood Press, sup1. 2006;15:18–26. doi:10.1080/08038020510046689.

 Google Scholar

Li J, Qin TL, Jiang H, et al. The efects of olmesartan on ambulatory blood pressures and blood pressure variability in patients with mild to moderate essential hypertension. Chin J Intern Med. 2014;53:788–792. doi:10.3760/cma.j.issn.0578-1426.2014.10.007.

 PubMedGoogle Scholar

Li J, Qin TL, Zhao LS, et al. Effecacy and safety of domestic and foreign olmesartan medoxomil in mild-moderate essential hypertension patients. Chin J Geriatr Heart Brain Ves Dis. 2014;16:1275–1278. doi:10.3969/j.issn.1009-0126.2014.12.013.

 Google Scholar

Lian FM, Tong XL, Xu LP, et al. Clinical study on jiangturuqinggan prescription for treating hypertension with metabolic syndrome. J Basic Chin Med. 2011;17:649–652. J doi:10.19945/j.cnki.issn.1006-3250.2011.06.029.

 Google Scholar

Mai WY, Ceng QY, Li YJ, et al. Effect of at_1 antagonist losartan on prostacycline and endothelin in patients with essential hypertension. Front Cardiovasc Med. 2000;27:239–242.

 Google Scholar

Malacco E, Piazza S, Meroni R, et al. Comparison of valsartan and irbesartan in the treatment of mild to moderate hypertension: a randomized, open-label, crossover study. Curr Ther Res Clin Exp. 2000;61(11):789–797. doi:10.1016/S0011-393X(00)90005-5.

 Web of Science ®Google Scholar

Malacco E, Omboni S, Volpe M, et al. Antihypertensive efficacy and safety of olmesartan medoxomil and ramipril in elderly patients with mild to moderate essential hypertension: the ESPORT study. J Hypertens. 2010;28(11):2342–2350. doi:10.1097/HJH.0b013e32833e116b.

 PubMedGoogle Scholar

Mallion J, Siche J, Lacourcière Y. ABPM comparison of the antihypertensive profiles of the selective angiotensin II receptor antagonists telmisartan and losartan in patients with mild-to-moderate hypertension. J Hum Hypertens. 1999;13(10):657–664. doi:10.1038/sj.jhh.1000925.

 PubMed Web of Science ®Google Scholar

Mallion JM, Omboni S, Barton J, et al. Antihypertensive efficacy and safety of olmesartan and ramipril in elderly patients with mild to moderate systolic and diastolic essential hypertension. Blood Press Suppl. 2011;1:3–11. doi:10.3109/08037051.2010.532332.

 PubMedGoogle Scholar

Mancia G, Korlipara K, van Rossum P, et al. An ambulatory blood pressure monitoring study of the comparative antihypertensive efficacy of two angiotensin II receptor antagonists, irbesartan and valsartan. Blood Press Monit. 2002;7(2):135–142. doi:10.1097/00126097-200204000-00008.

 PubMed Web of Science ®Google Scholar

Manzur F, Rico A, Romero JD, et al. Efficacy and safety of valsartan or chlorthalidone vs. Combined valsartan and chlorthalidone in patients with mild to moderate hypertension: the VACLOR study. Clin Med Insights Cardiol. 2018;12:1179546818796482. doi:10.1177/1179546818796482.

 Google Scholar

Matsumoto S, Shimodozono M, Miyata R, et al. Benefits of the angiotensin II receptor antagonist olmesartan in controlling hypertension and cerebral hemodynamics after stroke. Hypertens Res. 2009;32(11):1015–1021. doi:10.1038/hr.2009.143.

 PubMed Web of Science ®Google Scholar

Moltzer E, Mattace Raso FU, Karamermer Y, et al. Comparison of candesartan versus metoprolol for treatment of systemic hypertension after repaired aortic coarctation. Am J Cardiol. 2010;105(2):217–222. doi:10.1016/j.amjcard.2009.08.674.

 PubMed Web of Science ®Google Scholar

Munakata M, Nagasaki A, Nunokawa T, et al. Effects of valsartan and nifedipine coat-core on systemic arterial stiffness in hypertensive patients. Am J Hypertens. 2004;17(11 Pt 1):1050–1055. doi:10.1016/j.amjhyper.2004.06.028.

 PubMed Web of Science ®Google Scholar

Neutel J, Weber M, Pool J, et al. Valsartan, a new angiotensin II antagonist: antihypertensive effects over 24 hours. Clin Ther. 1997;19(3):447–458. doi:10.1016/s0149-2918(97)80129-4.

 PubMed Web of Science ®Google Scholar

Neutel JM, Kolloch RE, Plouin PF, et al. Telmisartan vs losartan plus hydrochlorothiazide in the treatment of mild-to-moderate essential hypertension–a randomised ABPM study. J Hum Hypertens. 2003;17(8):569–575. doi:10.1038/sj.jhh.1001592.

 PubMed Web of Science ®Google Scholar

Palatini P, Malacco E, Di SS, et al. Trough:peak ratio and smoothness index in the evaluation of 24-h blood pressure control in hypertension: a comparative study between valsartan/hydrochlorothiazide combination and amlodipine. Eur J Clin Pharmacol. 2002;57(11):765–770. doi:10.1007/s00228-001-0393-6.

 PubMed Web of Science ®Google Scholar

Palatini P, Jung W, Shlyakhto E, et al. Maintenance of blood-pressure-lowering effect following a missed dose of aliskiren, irbesartan or ramipril: results of a randomized, double-blind study. J Hum Hypertens. 2010;24(2):93–103. doi:10.1038/jhh.2009.38.

 PubMed Web of Science ®Google Scholar

Perez A, Cao C. The impact of azilsartan medoxomil treatment (capsule formulation) at doses ranging from 10 to 80 mg: significant, rapid reductions in clinic diastolic and systolic blood pressure. J Clin Hypertens. 2017;19:312–321. doi:10.1111/jch.12895.

 Web of Science ®Google Scholar

Qian YS, Wang XY, Huang GZ, et al. Treatment of 118 cases of essential hypertension with candesartan ester tablets. Chin J New Drugs Clin Rem. 2005;17:849–853. doi:10.3969/j.issn.1007-7669.2005.11.003.

 Google Scholar

Qin YP, Wang ZP, Li L. Comparative study on the efficacy of domestic felodipine and losartan intreatment of hypertension. Chin J New Drug. 2000;9:837–839. doi:10.3321/j.issn:1003-3734.2000.12.011.

 Google Scholar

Ribeiro AB, Mion D, Jr, Marin MJ, et al. Antihypertensive efficacy of amlodipine and losartan after two ‘missed’ doses in patients with mild to moderate essential hypertension. J Int Med Res. 2007;35(6):762–772. doi:10.1177/147323000703500604.

 PubMed Web of Science ®Google Scholar

Smolensky MH, Hermida RC, Portaluppi F. Comparison of the efficacy of morning versus evening administration of olmesartan in uncomplicated essential hypertension. Chronobiol Int. 2007;24(1):171–181. doi:10.1080/07420520600969277.

 PubMed Web of Science ®Google Scholar

Stanton A, Jensen C, Nussberger J, et al. Blood pressure lowering in essential hypertension with an oral renin inhibitor, aliskiren. Hypertension. 2003;42(6):1137–1143. doi:10.1161/01.HYP.0000101688.17370.87.

 PubMed Web of Science ®Google Scholar

Sun N, Feng Y, Gao P, et al. Efficacy and tolerability of once-daily 160 mg valsartan in chinese patients with mild to moderate hypertension. Exp Ther Med. 2017;13(3):1109–1116. doi:10.3892/etm.2017.4051.

 PubMed Web of Science ®Google Scholar

Tong XL, Lian FM, Zhou Q, et al. Prospective multicenter clinical trial of chinese herbal formula JZQG (jiang zhuo qing gan) for hypertension. Am J Chin Med. 2013;41(1):33–42. doi:10.1142/S0192415X13500031.

 PubMed Web of Science ®Google Scholar

Wang F, Hua L, Wang L, et al. To evaluate the efficacy and safety of domestic candesartan ester in treating hypertension by ambulatome blood pressure monitoring. Clin Cardiol. 2004;20:722–724. doi:10.3969/j.issn.1001-1439.2004.12.008.

 Google Scholar

Wang F, Wang L, Fan CM, et al. Randomized double blind observation of domestic candesartan ester/enalapril dynamic antihypertensive effect. Chin J Med. 2006;41:39–41. doi:10.3969/j.issn.1008-1070.2006.09.020.

 Google Scholar

Wang YM, Liu GC. Chronotherapy of telmisartan in the treatment of essential hypertension. Chin J Gerontol. 2011;31:756–758. doi:10.3969/j.issn.1005-9202.2011.05.012.

 Google Scholar

Wang W, Feng H, Gao W. Effect of low dose combination of common antihypertensive drugs on senile non-arytenoid hypertension. Chin J Gerontol. 2015;35:3281–3282. doi:10.3969/j.issn.1005-9202.2015.12.041.

 Google Scholar

Wang HY, Guo L, Wang JH, et al. Clinical trial of allisartan isoproxil tablets in the treatment of patients with essential hypertension. Chin J Clin Pharmacol. 2022;38:755–759. doi:10.13699/j.cnki.1001-6821.2022.08.001.

 Google Scholar

Williams B, Lacourcière Y, Schumacher H, et al. Antihypertensive efficacy of telmisartan vs ramipril over the 24-h dosing period, including the critical early morning hours: a pooled analysis of the PRISMA I and II randomized trials. J Hum Hypertens. 2009;23(9):610–619. doi:10.1038/jhh.2009.4.

 PubMed Web of Science ®Google Scholar

Wu SL, Wang RT, Xiang YJ, et al. Efficacy observation of telmisartan at different administration time in theTreatment of non-dipper hypertension. China Pharmacy. 2011;22:1294–1296.

 Google Scholar

Kawano Y, Sato Y, Yoshinaga K. A randomized trial of the effect of an angiotensin II receptor blocker SR47436 (irbesartan) on 24-hour blood pressure in patients with essential hypertension. Hypertens Res. 2008;31(9):1753–1763. doi:10.1291/hypres.31.1753.

 PubMed Web of Science ®Google Scholar

Tanigawara Y, Yoshihara K, Kuramoto K, et al. Comparative pharmacodynamics of olmesartan and azelnidipine in patients with hypertension: a population pharmacokinetic/pharmacodynamic analysis. Drug Metab Pharmacokinet. 2009;24(4):376–388. doi:10.2133/dmpk.24.376.

 PubMed Web of Science ®Google Scholar

Data availability statement

All data generated or analyzed during this study are included in this published article and its supplementary information files.