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Olmesartan in the Treatment of Hypertension in Elderly Patients: a Review of the Primary Evidence

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Abstract

Hypertension, particularly systolic hypertension, is prevalent in the elderly and increases with advancing age, in part because of age-related endothelial dysfunction and increased arterial stiffness. There is strong evidence from randomized clinical trials that supports the use of antihypertensive treatment for effective and sustained blood pressure (BP) control in older patients to reduce the risk of vascular-related morbidity and mortality, particularly cerebrovascular accidents, including stroke. Furthermore, current evidence and guidelines suggest that all major classes of antihypertensive agents are equally effective in controlling BP and preventing cardiovascular events in older patients. Diuretics are commonly used in elderly patients, but recent outcomes data have raised doubt about their long-term benefits. Renin–angiotensin system inhibitors have a better tolerability profile than diuretics. Extensive clinical evidence has demonstrated the excellent efficacy and tolerability profile of olmesartan medoxomil (OM)—an angiotensin II receptor blocker AT1 receptor antagonist—including in elderly patients. Randomized and observational studies have shown that OM provides effective BP control across the 24 h dosing interval in the elderly. It also has a good tolerability profile, a pharmacokinetic profile unaffected by age and a low propensity for drug interactions. An additional factor is that OM once-daily regimens are simple and straightforward, which can be an important factor in maintaining adherence to therapy in elderly patients. This article provides an overview of the main recent clinical evidence supporting the use of OM-based therapy in elderly patients with hypertension.

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Acknowledgments

Massimo Volpe has served on the scientific Advisory Boards of Daiichi-Sankyo, has received honoraria for lectures by Daiichi-Sankyo and has participated as a speaker or chairman in events supported by Menarini International, Malesci and Guidotti. Giuliano Tocci has no conflict of interest to disclose.

Editorial assistance for the preparation of this manuscript was provided by Mary Hines of inScience Communications, Springer Healthcare. This assistance was sponsored by Menarini International.

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Authors and Affiliations

  1. Chair and Division of Cardiology, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant’Andrea Hospital, University of Rome Sapienza, via di Grottarossa 1035-39, 00189, Rome, Italy

    Massimo Volpe & Giuliano Tocci

  2. IRCCS Neuromed, Pozzilli, Italy

    Massimo Volpe & Giuliano Tocci

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  1. Massimo Volpe
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  2. Giuliano Tocci
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Correspondence to Massimo Volpe.

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Volpe, M., Tocci, G. Olmesartan in the Treatment of Hypertension in Elderly Patients: a Review of the Primary Evidence. Drugs Aging 30, 987–998 (2013). https://doi.org/10.1007/s40266-013-0130-8

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