Time of angiotensin II receptor blockers intake and their antihypertensive effect: own experience of chronotherapy

Authors

  • O.L. Rekovets State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • O.O. Torbas State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • S.M. Kushnir State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • G.F. Primak State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • V.M. Granich State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • P.I. Sidorenko State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • S.A. Polischuk State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • G.V. Ponomareva State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • G.D. Radchenko State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • I.O. Zhivilo State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • O.Yu. Sirenko State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • N.A. Krushynska State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine
  • Yu.M. Sirenko State Institution “National Scientific Center “M.D. Strazhesko Institute of Cardiology” of the National Academy of Medical Sciences of Ukraine”, Kyiv, Ukraine

DOI:

https://doi.org/10.22141/2224-1485.13.4.2020.211954

Keywords:

arterial hypertension, chronotherapy, circadian rhythm, evening intake, morning intake

Abstract

Background. The purpose of our study was to evaluate the effect of angiotensin (AT) II receptor blockers — olmesartan, azilsartan, and telmisartan when taken in the morning or evening hours on blood pressure indicators during 24-hour monitoring. Materials and methods. The study included 126 patients with mild to moderate hypertension. The patients were divided into 6 groups: group 1 — 20 patients who took olmesartan 20–40 mg in the morning, group 2 — 20 patients took olmesartan 20–40 mg in the evening, group 3 — 21 patients took azilsartan 40–80 mg in the morning, group 4 — 20 patients took azilsartan 40–80 mg in the evening, group 5 — 22 patients took telmisartan 40–80 mg in the morning, group 6 — 23 patients took telmisartan 40–80 mg in the evening. Patients underwent initial and repeated examination after 3 months of therapy. Results. Evening intake of olmesartan led to a more pronounced decrease in 24 systolic blood pressure (SBP) (11.09 ± 2.30 versus 4.06 ± 2.25 mm Hg; p < 0.01). Changes in 24 diastolic blood pressure (DBP) were insignificant, although the decrease, when taken in the evening was more significant compared to the morning intake (8.38 ± 2.58 versus 3.38 ± 2.31 mm Hg, NS). Changes in 24SBP/24DBP while taking azilsartan in the evening or morning hours were significant but did not differ from each other (13.06 ± 2.65/9.76 ± 1.73 and 12.71 ± 1.62/7.00 ± 1.50 mm Hg). The decrease in 24SBP/24SBP on the background of telmisartan intake was significantly more pronounced with the morning intake compared to the evening intake (16.48 ± ± 2.86/12.56 ± 2.80 versus 4.93 ± 1.53/5.40 ± 1.89 mm Hg; p < 0.01) Thus, the morning intake more strongly reduced the average daily blood pressure while taking telmisartan, and the evening intake — while taking olmesartan. Azilsartan reduced blood pressure equally both when taken in the evening and in the morning. Achievement of target blood pressure with daily monitoring while taking olmesartan, azilsartan and telmisartan was 71.80, 71.05, and 75.61 %, respectively. Conclusions. The study of various AT II blockers (olmesartan, azilsartan, and telmisartan) has demonstrated their different properties in terms of impacting the daily blood pressure level depending on the time of administration. We did not reveal the class effect of the drugs by the time of their administration: olmesartan was more effective when taken in the evening, telmisartan — in the morning, and the effectiveness of azilsartan did not depend on the time of its administration. Achievements of target blood pressure while taking all three drugs according to 24-hour monitoring data were the same.

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Published

2020-08-01

Issue

Section

Clinical Researches