MORE study shows potential for vascular benefits in addition to BP lowering with olmesartan

Olmetec® (olmesartan medoxomil), licensed in the UK for essential hypertension, is the first ARB to suggest a regression of atherosclerosis (plaque volume (PV)) , a major risk factor for cardiovascular disease (CVD)1, according to a new study published on 10 December in the inaugural issue of Therapeutic Advances in Cardiovascular Disease. Regression of PV is a compelling clinical goal, with potential to prevent cardiovascular and cerebrovascular events. In the Multicentre Olmesartan Atherosclerosis Regression Evaluation (MORE)2 study the primary end point, common carotid - intima media thickness (CC-IMT), a surrogate risk factor for CVD, decreased after 2 years treatment with olmesartan. A post hoc analysis in patients with larger plaques demonstrated a significant reduction in PV compared to atenolol the active comparator, although change in PV for the whole study population only showed trend towards significance for olmesartan. This is a promising finding which provides a focus for further evaluation in future clinical studies.

In the MORE study, olmesartan did not significantly reduce plaque volume (PV) compared with the beta-blocker atenolol in the overall population. However a post hoc analysis of patients with above average plaques (=33?µl) at baseline (those at greater risk of cardiovascular events) olmesartan showed a significant reduction in PV by -8.9%, compared with a 2.4% increase with atenolol. In very large plaques the beneficial effect of olmesartan was even greater PV declined by -12.8% and increased by 2.1% respectively in the olmesartan and atenolol groups. Both olmesartan and atenolol patients showed a similar reduction in blood pressure2. The observed decrease in plaque volume may thus occur independently of blood pressure lowering and offers a further potential benefit of olmesartan.

The MORE findings add to Olmesartan's growing portfolio of vascular protective studies.3 - 8 "The MORE study is a landmark because it is the first study to show an anti-atherosclerotic effect using an ARB. This suggests that in patients with hypertension, in addition to effective blood pressure lowering, olmesartan may potentially protect against cardiovascular and organ damage, benefits that should be considered seriously when prescribing an anti-hypertensive agent in patients who already have atherosclerotic disease" said Dr Lina Izzat, Associate Specialist in Cardiology, Prince Phillip Hospital, Llanelli.

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