Effects of olmesartan on the renin-angiotensin-aldosterone system for patients with essential hypertension after cardiac surgery--investigation using a candesartan change-over study

Ann Thorac Cardiovasc Surg. 2011;17(5):487-93. doi: 10.5761/atcs.oa.11.01691. Epub 2011 Jul 27.


Background: Various angiotensin II receptor blockers are widely used for the treatment of hypertension in recent years. The results of large-scale clinical studies have shown that they have various efficacies: not only hypotensive effects but also organ protective effects. In this study, the effects of a change-over from candesartan to olmesartan on renin-angiotensin-aldsterone system, cardiomegaly and peripheral circulation were studied.

Methods: Participants enrolled in this trial were outpatients with essential hypertension after cardiac surgery who had received candesartan for more than one year. Fifty-six patients switched from candesartan to olmesartan. The primary endpoints were 1) renin activity, angiotensin II, aldosterone, and 2) left ventricular mass index (LVMI).

Results: It was clear that angiotensin II and aldosterone are decreased by the potent hypotensive effects of olmesartan in a change-over from candesartan to olmesartan. Since LVMI and BNP were decreased, inhibitory effects on myocardial hypertrophy were also confirmed.

Conclusion: In the present study, left ventricular hypertrophy and on arterial compliance were inhibited by a decrease in angiotensin II and aldosterone due to the change-over to olmesartan. In the future, protective effects on organs will be clarified by long-term observations.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aldosterone / blood
  • Analysis of Variance
  • Angiotensin II / blood
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Antihypertensive Agents / therapeutic use*
  • Arteries / drug effects
  • Arteries / physiopathology
  • Benzimidazoles / therapeutic use*
  • Cardiac Surgical Procedures*
  • Compliance
  • Drug Substitution*
  • Female
  • Hemodynamics / drug effects
  • Humans
  • Hypertension / blood
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / drug therapy
  • Hypertrophy, Left Ventricular / physiopathology
  • Imidazoles / therapeutic use*
  • Japan
  • Male
  • Middle Aged
  • Prospective Studies
  • Renin / blood
  • Renin-Angiotensin System / drug effects*
  • Tetrazoles / therapeutic use*
  • Time Factors
  • Treatment Outcome


  • Angiotensin II Type 1 Receptor Blockers
  • Antihypertensive Agents
  • Benzimidazoles
  • Imidazoles
  • Tetrazoles
  • Angiotensin II
  • Aldosterone
  • olmesartan
  • Renin
  • candesartan