Azelnidipine plus olmesartan versus amlodipine plus olmesartan on arterial stiffness and cardiac function in hypertensive patients: a randomized trial

Figures & data

Figure 1 Study protocol.

Modified with permission from Takami T, Saito Y. Effects of azelnidipine plus olmesartan versus amlodipine plus olmesartan on central blood pressure and left ventricular mass index: the AORTA study. Vasc Health Risk Manag. 383–390. © 2012 Dove Medical Press.⁵

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; CBP, central blood pressure; AIx, augmentation index; PWV, pulse wave velocity; LVMI, left ventricular mass index.

Table 1 Patient characteristics at baseline

	Olmesartan plus azelnidipine (n = 26)	Olmesartan plus amlodipine (n = 26)	P
Sex (male/female)	17/9	19/7	0.55
Age (years)	66.2 ± 4.4	67.5 ± 4.5	0.26
SBP (mmHg)	151.8 ± 5.5	151.9 ± 4.5	0.96
DBP (mmHg)	85.8 ± 5.1	86.1 ± 4.6	0.82
Heart rate (bpm)	73.7 ± 5.7	73.7 ± 6.9	1.00
Central BP (mmHg)	147.4 ± 5.3	146.4 ± 3.5	0.42
AIx (%)	92.0 ± 4.4	92.6 ± 3.3	0.55
baPWV (cm/s)	1890.7 ± 198.7	1845.9 ± 170.9	0.39
LVMI (g/m^2)	123.0 ± 3.3	123.0 ± 2.9	0.93
e′ (cm/s)	8.2 ± 0.6	8.2 ± 0.5	0.90
E/e′ ratio	12.3 ± 1.2	12.0 ± 1.2	0.35
E/A ratio	0.79 ± 0.07	0.79 ± 0.11	0.88
EF (%)	64.5 ± 2.5	65.5 ± 1.9	0.12
eGFR (mL/min/1.73 m^2)	66.3 ± 4.5	66.4 ± 4.0	0.90
HbA1c (%)	5.7 ± 1.1	5.8 ± 1.2	0.91
LDL (mg/dL)	112.2 ± 12.1	110.3 ± 16.2	0.64
HDL (mg/dL)	55.4 ± 8.1	56.0 ± 8.8	0.81
TG (mg/dL)	170.7 ± 60.6	154.0 ± 74.2	0.38
UA (mg/dL)	5.6 ± 0.8	5.4 ± 1.0	0.58
BMI (kg/m^2)	25.7 ± 1.1	25.8 ± 1.3	0.85
Diabetes, n	9	7	0.55

Note: Values are means ± SD.

Abbreviations: eGFR, estimated glomerular filtration rate; HbA_1c, hemoglobin A_1c; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TG, triglycerides; UA, uric acid; BMI, body mass index.

Figure 2 Patient disposition.

Table 2 Changes in hemodynamic parameters

	Olmesartan plus azelnidipine (n = 26)	Olmesartan plus amlodipine (n = 26)	P (time × group interaction)
SBP (mmHg)
Baseline	151.8 ± 5.5	151.9 ± 4.5
6 months	136.7 ± 3.1***	137.4 ± 3.3***
2 years	134.7 ± 4.5***	132.5 ± 5.6***	0.17
DBP (mmHg)
Baseline	85.8 ± 5.1	86.1 ± 4.6
6 months	82.7 ± 3.5***	83.7 ± 3.4**
2 years	82.9 ± 3.6***	82.4 ± 3.6***	0.26
Heart rate (bpm)
Baseline	73.7 ± 5.7	73.7 ± 6.9
6 months	69.1 ± 4.7***	74.8 ± 5.8
2 years	67.4 ± 4.3***	75.5 ± 7.1*	<0.001
Central BP (mmHg)
Baseline	147.4 ± 5.3	146.4 ± 3.5
6 months	133.2 ± 4.2***	138.2 ± 2.6***
2 years	131.4 ± 3.2***	137.8 ± 2.9***	<0.001
AIx (%)
Baseline	92.0 ± 4.4	92.6 ± 3.3
6 months	83.5 ± 2.7***	88.5 ± 3.3***
2 years	83.0 ± 2.7***	87.5 ± 3.6***	<0.001
baPWV (cm/s)
Baseline	1890.7 ± 198.7	1845.9 ± 170.9
6 months	1621.3 ± 156.7***	1745.8 ± 144.5***
2 years	1569.9 ± 131.2***	1739.6 ± 144.0***	<0.001
LVMI (g/m^2)
Baseline	123.0 ± 3.3	123.0 ± 2.9
6 months	116.5 ± 3.6***	120.0 ± 2.6***
2 years	115.5 ± 3.1***	120.2 ± 2.8***	<0.001
e′ (cm/s)
Baseline	8.2 ± 0.6	8.2 ± 0.5
6 months	8.8 ± 0.4***	8.7 ± 0.5***
2 years	8.9 ± 0.3***	8.7 ± 0.5***	0.27
E/e′ ratio
Baseline	12.3 ± 1.2	12.0 ± 1.2
6 months	10.9 ± 0.7***	11.1 ± 0.8***
2 years	10.6 ± 0.9***	11.3 ± 0.9**	0.002
E/A ratio
Baseline	0.79 ± 0.07	0.79 ± 0.11
6 months	0.86 ± 0.04***	0.84 ± 0.05**
2 years	0.89 ± 0.03***	0.84 ± 0.05**	0.03
EF (%)
Baseline	64.5 ± 2.5	65.5 ± 1.9
6 months	64.5 ± 2.4	64.6 ± 2.7
2 years	64.1 ± 2.6	64.9 ± 2.7	0.66

Notes: Value are means ± SD.

* P < 0.05;

** P < 0.01; and

*** P < 0.001 vs baseline.

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; AIx, augmentation index (AI normalized for an HR of 75 bpm); baPWV, brachial–ankle pulse wave velocity; LVMI, left ventricular mass index; e′, peak early diastolic mitral annular velocity; E, peak early diastolic transmitral flow; E/e′, ratio of E to e′; A, peak late diastolic transmitral flow; E/A, ratio of E to A; EF, ejection fraction.

Table 3 Univariate and multivariate regression analyses for the change in LVMI in all patients and in each treatment group

	All patients				Olmesartan plus azelnidipine				Olmesartan plus amlodipine
	Univariate		Multivariate		Univariate		Multivariate		Univariate		Multivariate
	r	P	β	P	r	P	β	P	r	P	β	P
SBP	0.18	0.21			0.48	0.01	0.23	0.03	0.27	0.18
DBP	−0.04	0.80			0.18	0.38			−0.11	0.58
HR	0.50	<0.001			0.08	0.71			0.23	0.25
CBP	0.68	<0.001	0.47	0.01	0.50	0.01			0.34	0.09
AIx	0.45	<0.001			0.61	0.001			−0.16	0.43
baPWV	0.80	<0.001	0.41	<0.001	0.71	<0.001	0.49	<0.001	0.67	<0.001	0.44	<0.001
e′	−0.49	<0.001			−0.56	0.003			−0.44	0.02
E/e′	0.58	<0.001			0.45	0.02			0.43	0.03
E/A	−0.49	<0.001			−0.55	0.003			−0.32	0.11
EF	−0.16	0.24			−0.26	0.20			−0.11	0.58
Adjusted R ^2			0.67	<0.001			0.57	<0.001			0.42	<0.001

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; AIx, augmentation index (AI normalized for an HR of 75 bpm); baPWV, brachial-ankle pulse wave velocity; LVMI, left ventricular mass index; e′, peak early diastolic mitral annular velocity; E, peak early diastolic transmitral flow; E/e′, ratio of E to e′; A, peak late diastolic transmitral flow; E/A, ratio of E to A; EF, ejection fraction.

Table 4 Univariate and multivariate regression analyses of the change in E/e′ ratio in all patients and in each treatment group

	All patients				Olmesartan plus azelnidipine				Olmesartan plus amlodipine
	Univariate		Multivariate		Univariate		Multivariate		Univariate		Multivariate
	r	P	β	P	r	P	β	P	r	P	β	P
SBP	0.09	0.55			0.15	0.47			0.19	0.35
DBP	−0.02	0.88			−0.002	0.99			0.05	0.82
HR	0.46	0.001	0.22	0.15	0.25	0.21			0.30	0.14
CBP	0.41	0.003			0.22	0.28			0.10	0.63
AIx	0.41	0.002			0.33	0.10			0.26	0.20
baPWV	0.62	<0.001	0.25	<0.001	0.59	0.001	0.35	0.001	0.43	0.03
LVMI	0.58	<0.001			0.45	0.02			0.43	0.03	0.18	0.031
EF	−0.10	0.49			0.28	0.16			−0.51	0.008	0.26	0.009
Adjusted R ^2			0.39	<0.001			0.33	0.001			0.34	0.003

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; AIx, augmentation index (AI normalized for an HR of 75 bpm); baPWV, brachial-ankle pulse wave velocity; LVMI, left ventricular mass index; EF, ejection fraction; E/e′, ratio of E to e′.

Table 5 Univariate and multivariate regression analyses of the change in E/A ratio in all patients and in each treatment group

	All patients				Olmesartan plus azelnidipine				Olmesartan plus amlodipine
	Univariate		Multivariate		Univariate		Multivariate		Univariate		Multivariate
	r	P	β	P	r	P	β	P	r	P	β	P
SBP	−0.15	0.28			−0.31	0.13			−0.16	0.43
DBP	−0.01	0.93			−0.01	0.95			−0.06	0.75
HR	−0.36	0.01			−0.27	0.19			−0.21	0.31
CBP	−0.50	<0.001			−0.44	0.02	0.20	0.14	−0.45	0.02
AIx	−0.50	<0.001	0.25	0.03	−0.52	0.007			−0.40	0.04	0.16	0.02
baPWV	−0.59	<0.001	0.21	0.001	−0.65	<0.001	0.34	0.002	−0.47	0.01	0.27	0.01
LVMI	−0.49	<0.001			−0.55	0.003			−0.32	0.11
EF	0.02	0.89			−0.08	0.69			0.09	0.67
Adjusted R ^2			0.38	<0.001			0.42	<0.001			0.33	0.004

Abbreviations: SBP, systolic blood pressure; DBP, diastolic blood pressure; AIx, augmentation index (AI normalized for an HR of 75 bpm); baPWV, brachial-ankle pulse wave velocity; LVMI, left ventricular mass index; EF, ejection fraction.

Takami T Saito Y Effects of azelnidipine plus olmesartan versus amlodipine plus olmesartan on central blood pressure and left ventricular mass index: the AORTA study Vasc Health Risk Manag 2011 7 383 390 21796252

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