A prospective comparative efficacy of azilsartan and telmisartan in hypertensive patients

Velvizhy R., Johan Pandian J.


Background: Hypertension (HT) is defined as either a sustained systolic blood pressure of greater than 140 mmHg or a sustained diastolic blood pressure of greater than 90 mmHg, according to joint national committee (JNC VIII) on hypertension.

Methods: A prospective, open, randomized parallel group comparative study of AZL versus telmisartan was done in patients of stage-I HT. The study included 80 patients, 40 in each group (group I and group II) coming to the Department of Pharmacology, Mahatma Gandhi Medical College and Research Institute, Pillayarkuppam, Pondicherry from January 2016 to December 2017. The study was conducted over 8 weeks. Group-I, patients received azilsartan 40-80 mg per day in divided doses and group-II, patients received telmisartan 40-80 mg per day in divided doses according to severity of hypertension.

Results: Patients receiving AZL 40 mg and telmisartan 40 mg showed a significant fall (p<0.05) in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 4 weeks and 8 weeks, when compared to baseline. The difference in SBP and DBP between group I (AZL) and II (telmisartan) was statistically significant at 4 weeks (p<0.05) and was highly significant at 8 weeks (p<0.001). Adverse effects such as nasopharyngitis, upper respiratory tract infection, gastroenteritis, headache, dizziness, and fatigue were reported with both drugs.

Conclusions: Reduction of BP with AZL was more as compared to telmisartan at 4 weeks and 8 weeks. Safety and tolerability were similar in both groups.


Telmisartan, Azilsartan, SBP, DBP

Full Text:



Karen W, Finkel R, Thomas A. Panavelil Lippincots illustrated reviews: Pharmacology. Sixth edition. Philadelphia: Wolters Kluwer; 2015:225.

Staessen JA, Wang JG, Thijs L. Cardiovascular protection and blood pressure reduction: a meta-analysis. Lancet. 2001;358:1305-15.

Turnbull F. Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively designed overviews of randomized trials. Lancet. 2003;362:1527-35.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High BP. Hypertension. 2003;42:1206-52.

European Society of Hypertension-European Society of Cardiology Guidelines Committee. 2003 European Society of Hypertension European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertension. 2003;21:1011-54.

Schmidt-Ott KM, Kagiyama S, Phillips MI. The multiple actions of angiotensin II in atherosclerosis. Regul Pept. 2000;93:65-77.

Reyes OJA, Plancarte AA, Hernandez CJR. Angiotensin II and the development of insulin resistance: implications for diabetes. Mol Cell Endocrinol. 2009;302:128-39.

Kohara Y, Imamiya E, Kubo K, Wada T, Inada Y, Naka T. A new class of angiotensin II receptor antagonists with a novel acidic bio-isostere. Bioorganic Med Chemistry Letters. 1995;5:1903-8.

Kohara Y, Kubo K, Imamiya E, Wada T, Inada Y, Naka T. Synthesis and angiotensin II receptor antagonistic activities of benzimidazole derivatives bearing acidic heterocycles as novel tetrazole bioisosteres. J Med Chem. 1996;39:5228-35.

Rakugi H, Enya K, Sugiura K, Ikeda Y. Comparison of the efficacy and safety of azilsartan with that of candesartan cilexetil in Japanese patients with grade III essential hypertension: a randomized, double-blind clinical study. Hypertens Res. 2012;35(5):552-8.

Naka T, Kubo K. A new class of di-acidic nonpeptide angiotensin II receptor antagonists: candesartan cilexetil. Curr Pharm Des. 1999;5:453-72.

Baker WL, White WB. Azilsartan medoxomil: a new angiotensin II receptor antagonist for treatment of hypertension. Ann Pharmacother. 2011;45:150615.