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Received: 8 May 2017/Accepted: 6 June 2017/Published online: 12 June 2017
© Springer International Publishing AG 2017
Abstract Olmesartan medoxomil is an antihypertensive drug of the class of angiotensin II type 1 (AT1) receptor antagonists (or blockers), characterized by tight and prolonged binding to AT1 receptor compared to other molecules within the same class. These characteristics produce effective and sustained blood pressure reductions in hypertensive patients at different cardiovascular risk profile with a good tolerability profile. After a brief description of the pharmacological characteristics of olmesartan, we will provide a thorough overview of the clinical studies that investigated its efficacy and safety in the clinical management of hypertensive patients both in monotherapy and in dual combination therapies with either thiazide diuretics or calcium channel blockers. These studies demonstrated that olmesartan-based antihypertensive strategy may indeed provide sustained BP control over the 24-h period in a wide proportion of hypertensive patients, thus contributing to a substantial progress in hypertension management. Finally, since growing evidence suggest that olmesartan may also exert potential favourable effects at vascular level, thereby antagonizing the vascular inflammatory process involved in the development and progression of atherosclerosis, the main clinical studies addressing this issue will be also discussed.
Keywords Hypertension Blood pressure control Triple combination therapy Angiotensin receptor blocker Olmesartan medoxomil Thiazide diuretic Calcium channel blocker Amlodipine besylate
1Introduction
Recent observational studies and epidemiological surveys demonstrated that effective and sustained blood pressure (BP) control is achieved in a relatively small proportion of treated hypertensive patients [1]. Indeed, treatment of hypertension represents a key strategy for preventing coronary artery disease, stroke, congestive heart failure and cardiovascular (CV) death [2]. Several interventions have been proposed by international guidelines for ameliorating hypertension management and control, mostly including integrated and multi-dimensional pharmacological and non-pharmacological strategies [3-5]. Among these interventions, a large body of evidence suggest that a more extensive use of combination therapy, mostly in fixed doses, may represent a cornerstone for a more effective treatment of hypertension [6]. Among different drug combinations currently available for the clinical management of hypertension, those based on the association of drugs inhibiting the renin-angiotensin system, thiazide diuretics and calcium channel blockers (CCBs) have demonstrated to be very effective in lowering BP levels with a high tolerability and safety profile.
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