Azilsartan: a newly approved angiotensin II receptor blocker.
Author(s): Lam S.
Affiliation(s): Department of Clinical Pharmacy Practice, College of Pharmacy and Allied Health
Professions, St. John's University, Queens, NY, USA. Lams1@stjohns.edu
Publication date & source: 2011, Cardiol Rev. , 19(6):300-4
Hypertension is a common chronic disease that leads to significant cardiovascular
morbidity and mortality. Blood pressure control is essential to prevent end-organ
complications, such as stroke, myocardial infarction, heart failure, or kidney
disease. Azilsartan is the eighth angiotensin II receptor blocker approved for
the management of hypertension, alone or in combination with other agents. At the
approved dosage, it reduces systolic blood pressure by 12 to 15 mm Hg and
diastolic blood pressure by 7 to 8 mm Hg. A higher dose of azilsartan (80 mg) was
superior to valsartan 320 mg or olmesartan 40 mg in lowering systolic blood
pressure in short-term studies. Additional blood pressure reduction is expected
when azilsartan is used adjunctively with a diuretic. However, the effects of
azilsartan on cardiovascular morbidity or mortality are still lacking. Azilsartan
is well tolerated; the most common side effects are headache and diarrhea. No
cases of hyperkalemia have been reported in 6-week clinical trials. Worsening of
renal function and hypotension should be monitored, particularly in those with
baseline risk factors. It is unknown whether azilsartan would join
angiotensin-converting enzyme inhibitors and other angiotensin receptor blockers
as the preferred hypertensive agents for end-organ protection. At this time,
azilsartan should be considered as an alternative agent for mild-to-moderate
hypertension, or as an adjunctive therapy when preferred agents fail to maintain
optimal blood pressure control. It is also an option for those patients who have
contraindications or cannot tolerate other antihypertensive agents, including dry
cough induced by angiotensin-converting enzyme inhibitors.
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