Abstract
Intensive blood pressure control is a desirable and obtainable goal in patients with hypertension, according to the most recent treatment guidelines from Europe and the US. Achieving target blood pressure depends on the efficacy of antihypertensive treatment and patient compliance. Olmesartan medoxomil, a non-peptidergic angiotensin AT1 receptor antagonist, has been shown to be effective and well tolerated. Continuation of initial treatment is higher with AT1 receptor antagonists than for any other class of antihypertensive drugs. Olmesartan medoxomil may also have end-organ protective effects that provide additional clinical benefit. Optimal blood pressure control may be achieved faster if initial treatment contains the most efficacious and well tolerated antihypertensive drug or drugs. The ongoing European study, known as OLMEBEST (Efficacy and safety of OLMEsartan: reduction of Blood pressure in the treatment of patients suffering from mild to moderate ESsenTial hypertension), will provide important information on the use of olmesartan medoxomil as an initial treatment for hypertension.
Similar content being viewed by others
References
MacMahon S. Antihypertensive drag treatment: the potential, expected and observed effects on vascular disease. J Hypertens Suppl 1990 Dec; 8(7): S239–44
Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC7 Report. JAMA 2003 May; 289(19): 2560–722
Isles CG, Walker LM, Beevers GD, et al. Mortality in patients of the Glasgow Blood Pressure Clinic. J Hypertens 1986 Apr; 4(2): 141–56
Meissner I, Whisnant JP, Sheps GS, et al. Detection and control of high blood pressure in the community: do we need a wake-up call? Hypertension 1999 Sep; 34(3): 466–71
Hajjar I, Kotchen TA. Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA 2003 Jul; 290(2): 199–206
Franklin SS, Jacobs MJ, Wong ND, et al. Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001 Mar; 37(3): 869–74
Phillips LS, Branch WT, Cook CB, et al. Clinical inertia. Ann Intern Med 2001 Nov; 135(9): 825–34
European Society of Hypertension. European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003 Jun; 21(6): 1011–53
Menard J, Chatellier G. Limiting factors in the control of BP: why is there a gap between theory and practice? J Hum Hypertens 1995 Jul; 9 Suppl.2: S19–23
Primatesta P, Brookes M, Poulter NR. Improved hypertension management and control: results from the health survey for England 1998. Hypertension 2001 Oct; 38(4): 827–32
Hansson L, Zanchetti A. The Hypertension Optimal Treatment (HOT) study: 24-month data on blood pressure and tolerability. Blood Press 1997 Sep; 6(5): 313–7
Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001 Sep; 345(12): 861–9
Dahlöf B, Devereux RB, Kjeldsen SE, 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; 359(9311): 995–1003
Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001 Sep; 345(12): 851–60
Bloom BS. Continuation of initial antihypertensive medication after 1 year of therapy. Clin Ther 1998 Jul–Aug; 20(4): 671–81
Conlin PR, Gerth WC, Fox J, et al. Four-year persistence patterns among patients initiating therapy with the angiotensin II receptor antagonist losartan versus other antihypertensive drug classes. Clin Ther 2001 Dec; 23(12): 1999–2010
Mizuno M, Sada T, Ikeda M, et al. Pharmacology of CS-866, a novel nonpeptide angiotensin II receptor antagonist. Eur J Pharmacol 1995 Oct; 285(2): 181–8
Schwocho LR, Masonson HN. Pharmacokinetics of CS-866, a new angiotensin II receptor blocker, in healthy subjects. J Clin Pharmacol 2001 May; 41(5): 515–27
Püchler K, Laeis P, Stumpe KO. Blood pressure response, but not adverse event incidence, correlates with dose of angiotensin II antagonist. J Hypertens Suppl 2001 Jun; 19(1): S41–8
Neutel JM. Clinical studies of CS-866, the newest angiotensin II receptor antagonist. Am J Cardiol 2001 Apr; 87 Suppl. 8A: 37C–43C
Neutel JM, Elliott WJ, Izzo JL, et al. Antihypertensive efficacy of olmesartan medoxomil, a new angiotensin II receptor antagonist, as assessed by ambulatory blood pressure measurements. J Clin Hypertens 2002 Sep–Oct; 4(5): 325–31
Brunner HR, Laeis P. Clinical efficacy of olmesartan medoxomil. J Hypertens Suppl 2003 May; 21(2): S43–6
White WB. Relevance of blood pressure variation in the circadian onset of cardiovascular events. J Hypertens 2003; 21 Suppl. 6: S9–15
Püchler K, Nussberger J, Laeis P, et al. Blood pressure and endocrine effects of single doses of CS-866, a novel antiotensin II antagonist, in salt-restricted hypertensive patients. J Hypertens 1997; 15: 1809–12
Oparil S, Williams D, Chrysant SG, et al. Comparative efficacy of olmesartan, losartan, valsartan, and irbesartan in the control of essential hypertension. J Clin Hypertens 2001 Sep–Oct; 3(5): 283–91
Turnbull F. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists' Collaboration. Lancet 2003; 362: 1527–35
Ball KJ, Williams PA, Stumpe KO. Relative efficacy of an angiotensin II antagonist compared with other antihypertensive agents: olmesartan medoxomil versus antihypertensives. J Hypertens Suppl 2001 Jun; 19 Suppl. 1: S49–56
Neutel JM. Optimal blood pressure control: contribution of olmesartan. Presentation at the 13th European Meeting on Hypertension; 2003 Jun 13–17; Milan
Chrysant SG, Weber MA, Wang AC, et al. Evaluation of antihypertensive therapy with the combination of olmesartan medoxomil and hydrochlorothiazide. Am J Hypertens 2004 Mar; 17(3): 252–9
Wehling M. Can the pharmacokinetic characteristics of olmesartan medoxomil contribute to the improvement of blood pressure control? Clin Ther 2004; 26 Suppl. A: A21–7
Kannel WB. Framingham Study insights into hypertensive risk of cardiovascular disease. Hypertens Res 1995 Sep; 18(3): 181–96
Klag MJ, Whelton PK, Randall BL, et al. Blood pressure and end-stage renal disease in men. N Engl J Med 1996 Jan; 334(1): 13–8
Unger T. The role of the renin-angiotensin system in the development of cardiovascular disease. Am J Cardiol 2002 Jan; 89(2A): 3A–9A
Bakris GL, Williams M, Dworkin L, et al. Preserving renal function in adults with hypertension and diabetes: a consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am J Kidney Dis 2000 Sep; 36(30): 646–61
Cohn JN, Tognoni G. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure: Valsartan Heart Failure Trial Investigators. N Engl J Med 2001 Dec; 345(23): 1667–75
Okin PM, Devereux RB, Jern S, et al. Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Circulation 2003 Aug; 108(6): 684–90
Bakris GL, Weir MR, Shanifar S, et al. Effects of blood pressure level on progression of diabetic nephropathy: results from the RENAAL study. Arch Intern Med 2003 Jul; 163(13): 1555–65
Parving HH, Lehnert H, Brochner-Mortensen J, et al. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001 Sep; 345(12): 870–8
Lithell H, Hansson L, Skoog I, et al. The Study On Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hypertens 2003 May; 21(5): 875–86
Nangaku M, Miyata T, Sada T, et al. Anti-hypertensive agents inhibit in vivo the formation of advanced glycation end products and improve renal damage in a type 2 diabetic nephropathy rat model. J Am Soc Nephrol 2003 May; 14(5): 1212–22
Ohki R, Yamamoto K, Ueno S, et al. Effects of olmesartan, an angiotensin II receptor blocker, on mechanically-modulated genes in cardiac myocytes. Cardiovasc Drugs Ther 2003 May; 17(3): 231–6
Koike H. New pharmacologic aspects of CS-866, the newest angiotensin II receptor antagonist. Am J Cardiol 2001 Apr; 87 Suppl. 8A: 33C–6C
Koike H, Sada T, Mizuno M. In vitro and in vivo pharmacology of olmesartan medoxomil, an angiotensin II type AT1 receptor antagonist. J Hypertens Suppl 2001 Jun; 19 Suppl. 1: S3–14
Böhm M. Shortening the way to optimal blood pressure control. Presentation at the 13th European Meeting on Hypertension; 2003 Jun 13–17; Milan
Acknowledgements
This paper is based on presentations given at a satellite symposium held as part of a meeting of the European Society of Hypertension in Milan, Italy, 13 June 2003. The symposium was sponsored by Sankyo Pharma GmbH. The authors would like to thank Professor José L. Rodicio of the University of Madrid, Spain, and Professor Anthony M. Heagerty of Manchester Royal Infirmary, UK, who co-chaired the symposium.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Unger, T., McInnes, G.T., Neutel, J.M. et al. The Role of Olmesartan Medoxomil in the Management of Hypertension. Drugs 64, 2731–2739 (2004). https://doi.org/10.2165/00003495-200464240-00002
Published:
Issue Date:
DOI: https://doi.org/10.2165/00003495-200464240-00002