557 INTER-DRUG DIFFERENCES OF ARBS IN UNCONTROLLED HYPERTENSIVE PATIENTS

Abstract

Background: Angiotensin-II receptor blockers (ARBs) are widely used for hypertensive patients because of beneficial class effects. It is uncertain, however, whether are there any differences in clinical effects among each ARB or not. Methods: We enrolled uncontrolled hypertensive patients treated by any ARB alone or combined for clinical trials. Data of basic characteristics, blood test and ambulatory blood pressure monitoring (ABPM) were collected. We analyzed the data by each ARB. Results: We enrolled 211 patients treated with candesartan (74), valsartan (62), telmisartan (30), losartan (28) and olmesartan (17). Average office blood pressure (BP) was 150.7 ± 15.3 /83.0 ± 11.2 mmHg, and average 24-hour BP was 139.5 ± 13.9/78.2 ± 9.0 mmHg. There were no differences in office BP, 24-hour BP and day time BP among ARBs. But night time BP was significantly low in patients with olmesartan (p < 0.01), and the difference of BP between day time and night time was also large in patients with olmesartan. Although there were no differences in office and ambulatory BPs, ambulatory arterial stiffness index (AASI), a marker of arterial stiffness, was significantly high in patients with candesartan (candesartan 0.57 ± 0.12 vs. others 0.52 ± 0.10, p = 0.002). This difference was significant after adjustment of background. Conclusion: Although office BP distributes similar ranges, there may be some differences in 24-hour profile of ambulatory BP within each ARB, and the differences could be related future organ damages.