Effects of Allisartan on Uric Acid, Left Atrial, Left Ventricular, and Artery Stiffness in Mild‐to‐Moderate Essential Hypertension

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Abstract
This study aimed to explore the effects of allisartan in mild‐to‐moderate essential hypertension. This is a randomized, double‐blind, crossover design involving 98 patients with mild‐to‐moderate essential hypertension. Participants were randomized and divided into two groups: Group A (baseline—olmesartan—allisartan) and Group B (baseline—allisartan—olmesartan). Each treatment phase included 12 weeks, and participants were administered allisartan (240 mg) or olmesartan (20 mg) once daily. After treatment, both allisartan and olmesartan led to a significant decrease in systolic blood pressure (SBP) levels from baseline (Δ = 6.50 mmHg, p < 0.001 and Δ = 5.64 mmHg, p = 0.002, respectively), with no significant difference between the two drugs. Notably, allisartan led to a significant decrease in diastolic blood pressure (DBP) levels from baseline (Δ = 3.39 mmHg, p = 0.016), while olmesartan did not (Δ = 2.09 mmHg, p = 0.126), allisartan exhibited a more pronounced reduction in DBP compared to olmesartan (Δ = 3.66 mmHg, p = 0.001). 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 = −7.26 µmol/L, p = 0.991). 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 (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). In Conclusion, allisartan 240 mg and olmesartan 20 mg once daily achieve broadly similar reductions in blood pressure, improving left heart structure and function, mitigating arterial stiffness in individuals with mild‐to‐moderate essential hypertension. Compared to olmesartan, allisartan demonstrates significant reductions in serum UA.

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