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

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.