Abstract 16455: Age-Related Difference in Sleep Pressure Lowering Effect Between Angiotensin II Receptor Blocker and Calcium Channel Blocker in Asian Hypertensives: ACS-1 Study
Background: Sleep blood pressure (BP), which is partly determined by salt sensitivity and intake, is an important cardiovascular risk in hypertensives. There are no studies on age-related differences of sleep BP lowering effect between angiotensin II receptor blockers (ARB) and calcium channel blockers (CCB) in Asians with high salt intake.
Method: The Azilsartan Circadian and Sleep pressure-the 1st (ACS-1) study was a multicenter, randomized, open-label, 2 parallel-group study conducted to investigate the efficacy of 8-week oral treatment with ARB (azilsartan 20 mg), compared with CCB (amlodipine 5 mg) on sleep BP as evaluated by ambulatory BP monitoring.
Results: Amlodipine treatment demonstrated statistically significant greater reductions than azilsartan in sleep BP in the total group, especially only in the elderly hypertensives aged ≥60 years old (Table). There was no statistically significant difference in sleep BP control rate between the 2 groups overall. In patients <60 years old, the azilsartan group had significantly higher well-controlled sleep BP compared with the amlodipine group (P=0.014), while there was no significant difference in patients ≥60 years old (Table). Similar results were found for awake BP and 24-hr BP.
Conclusion: These results suggest that ARB is more effective in controlling BP in the younger hypertensives and CCB in the elderly hypertensives, supporting recommendations of the ASH/ISH and NICE guidelines of differentiating treatment according to age. Age-related options of antihypertensives may also be effective in salt-sensitive Asian hypertensive patients with high salt intake.
Author Disclosures: K. Kario: Research Grant; Significant; Teijin Pharma Limited. Honoraria; Significant; Takeda Pharmaceutical Co., Ltd., Mochida Pharmaceutical Company Limited, Daiichi Sankyo Co., Ltd.. S. Hoshide: None.
- © 2014 by American Heart Association, Inc.