An observational comparative study of different doses of azilsartan and with chlorthalidone combination in moderate hypertension

Tamoghna Maiti, Sonai Mandal, Ratul Banerjee, Sourav Chakrabarty, Amrita Panda


Background: High blood pressure (BP) is one of the significant non-communicable diseases that are of high prevalence in our country. Hypertension (HTN) is responsible cause of 57% of stroke and 24% of coronary heart disease deaths in India. Eight classes of medications are currently used in the treatment of hypertension. Azilsartan medoxomil is a newly added FDA approved drug to the ARB class of antihypertensive agents. azilsartan and chlorthalidone combination is also got the FDA approval. There is limited study in between these two groups regarding efficacy especially in rural Bengal.

Methods: A prospective observational study was done in medicine OPD of Bankura Sammilani Medical College for twelve weeks with two groups that are azilsartan (80mg) and fixed dose combination of azilsartan (40mg) plus chlorthalidone (12.5mg) in the age group of 18 to 55years of moderate hypertensive patients. Change of heart rate was assessed as safety parameter.

Results: It was found that both the group of drugs are very much effective in lowering blood pressure constantly in respect of both systolic and diastolic BP but azilsartan monotherapy in high dose reduce systolic blood pressure slightly high. Significant change of heart rate was not seen with both the groups.

Conclusions: Both the group was effective as well as safe in hypertensive patients.


Azilsartan, Blood pressure, Chlorthalidone, Heart rate

Full Text:



Gupta R. Trends in hypertension epidemiology in India. J Human Hypertension. 2004 Jan 5;18(2):73.

Gupta R, Gupta S. Hypertension in India: Trends in prevalence, awareness, treatment and control. RUHS J Health Sci. 2017;2(1):40-6.

Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet. 2005 Jan 15;365(9455):217-23.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec 15;380(9859):2224-60.

Noncommunicable diseases country profiles 2011. Available at: Accessed 10 May 2013.

Edarbi® (prescribing information) Deerfield, IL: Takeda Pharmaceuticals America, Inc; 2012. Available at: Accessed 22 February, 2016.

Cheng JW. Azilsartan/chlorthalidone combination therapy for blood pressure control. Integrated Blood Pressure Control. 2013;6:39-48.

McAinsh J, Bastain W, Young J, Harry JD. Bioavailability in man of atenolol and chlorthalidone from a combination formulation. Biopharmaceut Drug Disposition. 1981 Apr;2(2):147-56.

Khan MA, Neckář J, Cummens B, Wahl GM, Imig JD. Azilsartan decreases renal and cardiovascular injury in the spontaneously hypertensive obese rat. Cardiovasc Drugs Therapy. 2014 Aug 1;28(4):313-22.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-72.

Cushman WC, Ford CE, Cutler JA, Margolis KL, Davis BR, Grimm RH, et al. Original Papers. Success and predictors of blood pressure control in diverse north american settings: The Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). J Clin Hypertension. 2002 Nov;4(6):393-404.

Dahlöf B, Devereux RB, Kjeldsen SE, Julius S, Beevers G, de Faire U, et al. Cardiovascular morbidity and mortality in the losartan intervention for endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol. Lancet. 2002 Mar 23;359(9311):995-1003.

Pepine CJ, Handberg EM, Cooper-DeHoff RM, Marks RG, Kowey P, Messerli FH, et al. A calcium antagonist vs a non–calcium antagonist hypertension treatment strategy for patients with coronary artery disease: the International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA. 2003 Dec 3;290(21):2805-16.

Dahlöf B, Sever PS, Poulter NR, Wedel H, Beevers DG, Caulfield M, et al. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial. Lancet. 2005 Sep 10;366(9489):895-906.