Effects of allisartan on uric acid, left atrial, left ventricular and artery stiffness in mild-to-moderate essential hypertension

Objective: Our study aimed to explore the effects of allisartan on blood pressure, uric acid (UA), left atrial, left ventricular structure and function and artery stiffness in mild-to-moderate essential hypertension. Design and method: Our study is a randomised, double-blind, crossover design involving 98 patients with mild-to-moderate essential hypertension. Participants were administered allisartan (240mg) or olmesartan (20mg) once daily for 12 weeks each in varying sequences. Results: Both allisartan and olmesartan led to a significant decrease in systolic blood pressure (SBP) levels from baseline, with no significant difference between the two drugs (δ= 6.5mmHg, P<0.001 and δ= 5.64mmHg, P=0.002). Notably, allisartan exhibited a more pronounced reduction in diastolic blood pressure compared to olmesartan (δ= 3.66mmHg, P=0.001), with superior efficacy in lowering diastolic blood pressure (DBP) (δ= 3.39mmHg, P=0.016). Allisartan significantly dropped serum UA levels (δ= 26.37 μmol/L, P<0.001), whereas olmesartan did not achieve a significant reduction compared to allisartan (δ= 33.63 μmol/L, P<0.001). In terms of cardiac and artery stiffness, allisartan demonstrated significant reductions in left atrial volume index (LAVI) (δ= 2.86 ml/m2, P<0.001), left ventricular mass index (LVMI) (δ= 4.82 g/m2, P=0.010) and ankle-brachial pulse wave velocity (baPWV) (δ= 154.49 cm/s, P<0.001), all-surpassing olmesartan significantly (all P<0.01). Conclusions: In conclusion, compared to olmesartan, allisartan demonstrates significant reductions in serum UA, blood pressure, LAVI, LVMI and baPWV in patients with mild to moderate essential hypertension. This study provides new evidence supporting the efficacy of allisartan in treating mild-to-moderate essential hypertension and reducing serum UA levels in this population.