PP.05.13] AZILSARTAN MEDOXOMIL PROPORTIONALLY DECREASES CENTRAL AND BRACHIAL 24-H AMBULATORY BLOOD PRESSURE IN DIABETIC PATIENTS WITH DIFFICULT-TO-CONTROL ARTERIAL HYPERTENSION

Abstract

Objective: Ambulatory monitoring of central blood pressure (BP) and arterial stiffness is a new technique for evaluation of antihypertensive drugs efficacy. The aim of the study was to assess changes in ambulatory brachial and central BP and AIx after azilsartan medoxomil (AM) 40 mg adjunction to treatment regimen in hypertensive type 2 diabetic patients. Design and method: AM 40 mg was given as substitution drug to ACEi to 20 hypertensive patients (8 male, age 58 + 10 years) with clinic BP >140/90 mmHg, 24-h BP >130/80 mmHg and/or daytime BP>135/85 mmHg previously treated with an ACEI and a second drug from another class. ABPM was done with BPLab VASOTENS (OOO Petr Telegin, Nizhniy Novgorod, Russia). Brachial and aortic BP changes as well as changes in 24-h, day- and nighttime AIx were evaluated. p < 0,05 was considered significant. Results: Significant (p < 0,05 vs baseline) decrease in 24-h, day- and nighttime BP after 4 weeks of Azilsartani medoxomil adjunction was observed: for brachial SBP, respectively, from 150 + 10 to 134 + 8, from 150 + 10 to 134 + 10, from 148 + 15 to 132 + 12 mmHg, for brachial pulse pressure (PP) from 54 + 10 to 48 + 9, from 54 + 8 to 46 + 8, from 56 + 10 to 48 + 7 mmHg. For aortic SBP corresponding changes were from 139 + 10 to 126 + 9, from 140 + 10 to 126 + 8, from 138 + 12 to 128 + 10 mmHg, for aortic PP, respectively, 46 + 6 to 38 + 5, from 44 + 6 to 36 + 8, from 46 + 7 to 38 + 6 mmHg. AIxHR75 bpm decreased at daytime from 28,3 + 12,6 to 21,7 + 10,1%, at night-time from 32,2 + 10 to 26 + 9%. Increase in PP amplification was observed also and was more evident in nighttime: baseline difference between brachial and aortic PP was 10,0 + 3,2 for daytime, 10,0 + 3,2 mmHg for nighttime, after azilsartan medoxomili treatment 10,7 + 2,6 and 10,2 + 2,8 mmHg, respectively (p < 0,05). Conclusions: Azilsartan medoxomil decreases significantly either brachial or aortic SBP and PP, as well decreases aortic PP augmentation. In hypertensive diabetic patient PP amplification was similar at day- and nighttime before and after treatment meaning proportional decrease of brachial and central SBP and PP.