Comparative study of efficacy and adverse effects profile of azilsartan, olmesartan and candesartan in the control of essential hypertension

Background: Hypertension has been identified as the leading risk factor for mortality worldwide. It may lead to damage of heart, kidney, brain, vasculature and the other organs results in premature morbidity and death. The angiotensin receptor blockers are effective antihypertensive agent with excellent tolerability profiles. Azilsartan medoximil is a new ARB recently approved for treatment of hypertension. The objective of the study was to compare efficacy and tolerability of once daily treatment of the new angiotensin type1 receptor blocker (ARB) Azilsartan with Olmesartan and Candesartan.Methods: The study was a prospective, randomized open label comparison. Total 411 patients were recruited for the study. Patients were divided into four groups. Group A comprising of 105 patients received azilsartan (40mg), Group B comprising of 106 patients received azilsartan (80mg), Group C comprising of 102 patients received olmesartan (40mg) and Group D comprising of 98 patients received candesartan (12mg). Blood pressure was monitored at base line, after 2 weeks, 4 weeks and 8 weeks of treatment.Results: All groups were well matched in terms of age, weight, clinical findings and laboratory values. All drugs reduced both systolic blood pressure (SBP) and Diastolic blood pressure (DSP) significantly, but the reduction in SBP and DSP with azilsartan (80mg) was significantly greater than other drugs. The difference in BP reduction between azilsartan (40mg) and olmesartan (40mg) were not significant but both azilsartan (40mg) and olmesartan (40mg) were significantly more effective than candesartan(12mg).Conclusions: The study indicates that azilsartan (80mg) is more effective in the control of hypertension than olmesartan and candesartan with similar safety profile.