Carotid intima-media thickness and plaque volume changes following 2-year angiotensin II-receptor blockade. The Multicentre Olmesartan atherosclerosis Regression Evaluation (MORE) study

Ther Adv Cardiovasc Dis. 2007 Dec;1(2):97-106. doi: 10.1177/1753944707085982.


Objective: The Multicentre Olmesartan atherosclerosis Regression Evaluation (MORE) study was a double-blind trial in patients with hypertension at increased cardiovascular risk with carotid wall thickening and a defined atherosclerotic plaque that used non-invasive 2- and 3-dimensionaL (D) ultrasound (US), to compare the effects of a 2-year treatment based on either olmesartan medoxomil or atenolol on common carotid (CC) intima-media thickness (IMT) and plaque volume (PV).

Methods: A total of 165 patients (with systolic/diastolic blood pressure 140-180/ 90-105 mmHg) were randomized to receive either olmesartan (20-40 mg/day) or atenolol (50-100 mg/day). US was performed at baseline and 28, 52 and 104 weeks. The primary efficacy outcome was the change from baseline ( Delta) in CC-IMT assessed by 2D US. Secondary outcomes included Delta PV assessed by 3D US and blood pressure (BP).

Results: Olmesartan and atenolo produced comparable significant reductions in CC-IMT; mean Delta IMT (SEM) was -0.090 (0.015) mm for oLmesartan and -0.082 (0.014) mm for atenolol. Mean Delta PV was -4.4 (2.3) microl and 0.1 (1.5) microl in the olmesartan and atenolol treated subjects, respectively, without significant between-treatment differences. In the subgroup of patients with baseLine PV > or = median (33.7 microl), significant between-treatment differences existed in Delta PV (p = 0.023), because PV regressed significantly with olmesartan (Delta PV: -11.5 (4.4) microl) but not with atenolol ( Delta PV: 0.6 (2.5) microl). In these patients BP reductions were comparabLe.

Conclusions: Carotid IMT and BP decreased similarly with olmesartan and atenolol, but only olmesartan reduced the volume of larger atherosclerotic plaques.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage
  • Adult
  • Aged
  • Angiotensin II Type 1 Receptor Blockers / administration & dosage*
  • Atenolol / administration & dosage
  • Carotid Arteries / diagnostic imaging*
  • Carotid Arteries / drug effects
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / drug therapy*
  • Female
  • Humans
  • Hypertension / drug therapy
  • Imidazoles / administration & dosage*
  • Male
  • Middle Aged
  • Pilot Projects
  • Tetrazoles / administration & dosage*
  • Treatment Outcome
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / drug effects
  • Tunica Media / diagnostic imaging
  • Tunica Media / drug effects
  • Ultrasonography


  • Adrenergic beta-Antagonists
  • Angiotensin II Type 1 Receptor Blockers
  • Imidazoles
  • Tetrazoles
  • Atenolol
  • olmesartan