Clinic and home blood pressure lowering effect of an angiotensin receptor blocker, fimasartan, in postmenopausal women with hypertension

Angiotensin receptor blockers may be an appropriate first-line agent for postmenopausal women with hypertension because the activation of renin-angiotensin-aldosterone system is suggested as one possible mechanism of postmenopausal hypertension. However, there are few studies substantiating this effect. This study aimed to investigate clinic and home blood pressure (BP) lowering effect of fimasartan, a new angiotensin receptor blocker, in postmenopausal women with hypertension. Among patients with hypertension enrolled in K-Mets Study, 1373 women with fimasartan as a first antihypertensive drug and 3-months follow-up data were selected. They were divided into 2 groups; premenopausal women (pre-MPW; n=382, 45.3±4.6 years) and postmenopausal women (post-MPW; n=991, 60.9±8.2 years). Baseline clinic systolic BP was not different (pre-MPW; 152.9±15.2 vs. post-MPW; 152.8±13.5 mm Hg), but diastolic BP was lower in post-MPW (pre-MPW; 95.7±9.4 vs. post-MPW; 91.9±9.4 mm Hg, P<0.001). After 3-month treatment, clinic BP declined effectively without significant differences between 2 groups (Δsystolic/diastolic BP: pre-MPW; -25.7±17.7/-14.2±11.3 vs. post-MPW; -25.7±16.3/-13.1±10.9 mm Hg). Home morning and evening systolic BP decreased similarly in both groups (Δmorning/evening systolic BP: pre-MPW; -21.3±17.9/-23.1±15.8 vs. post-MPW; -20.4±17.3/-20.2±19.2 mm Hg). Fimasartan also significantly decreased the standard deviations of home morning and evening systolic BP of pre-MPW and post-MPW. Fimasartan was a similarly effective BP lowering agent in both post-MPW and pre-MPW with hypertension, and it also decreased day-to-day BP variability.