Comparative effect of candesartan and amlodipine, and effect of switching from valsartan, losartan, telmisartan and olmesartan to candesartan, on early morning hypertension and heart rate

Figures & data

Table I. Study name and number of cases and institutes.

Study name	Number of cases	Number of institute
Protocol 1: Comparison study		6
Candesartan group	36
Amlodipine group	22
Protocol 2: Switch to candesartan study	50	8
Summary	108	11

Figure 1. Profile of Protocol 1 and Protocol 2.

Table II. Characteristics of patients in Protocol 1.

	Candesartan group (n = 36)	Amlodipine group (n = 22)	p-value
Age	67.4 ± 7.99	65.9 ± 11.5	NS
BMI	23.3 ± 2.73	25.8 ± 3.47	p < 0.01
Dyslipidemia	10 (28%)	7 (32%)	NS
Diabetes mellitus	0 (0%)	4 (18%)	p < 0.05
Cardiac disease	5 (14%)	3 (14%)	NS
Cerebrovascular disease	2 (6%)	1 (5%)	NS
HbA1c	5.33 ± 0.51	5.16 ± 0.23	NS
Creatinine	0.77 ± 0.186	0.72 ± 0.125	NS
BUN	17.4 ± 4.59	13.9 ± 3.72	NS
TC	205.8 ± 39.97	196.44 ± 37.96	NS
LDL-C	121.00 ± 35.72	129.56 ± 30.57	NS
HDL-C	61.2 ± 20.0	52.0 ± 8.29	NS
TG	146.42 ± 56.34	132.45 ± 56.34	NS

BMI, body mass index; BUN, blood urea nitrogen; TC, total cholesterol; LDL-C, low-density lipoprotein; HDL-C, high-density lipoprotein; TG, trigylcerides.

Figure 2. (A) Changes in early morning blood pressure; (B) changes in office blood pressure. SBP, systolic blood pressure; DBP, diastolic blood pressure.

Figure 3. (A) Decrease in early morning blood pressure; (B) decrease in office blood pressure.

Figure 4. Changes in heart rate in the early morning and at the office.

Table III. ARBs switched to candesartan and doses of candesartan switched.

ARBs (n)	Low dose	Standard dose	High dose
Losartan (n = 7)		7
Valsartan (n = 24)	1	21	2
Telmisartan (n = 12)		11	1
Olmesartan (n = 7)	1	6
Summary (n = 50)	2	45	3
	↓	↓	↓
Candersartan	4 mg	8 mg	12 mg

Standard dose: losartan 50 mg, varsartan 80 mg, telmisartan 40 mg, olmesartan 20 mg, candesartan 8 mg.

Figure 5. Changes in systolic and diastolic blood pressure after switching from other angiotensin receptor blockers (ARBs) to candesartan.

Figure 6. (A) Changes in early morning blood pressure after switching from each angiotensin receptor blocker (ARB) to candesartan; (B) changes in office blood pressure after switching from each ARB to candesartan.

Figure 7. Changes in heart rate after switching from other angiotensin receptor blockers (ARBs) to candesartan.