ESC Congress 2026 Abstract · Oct 26, 2026

Differential effects of azilsartan-based combinations on arterial stiffness and central hemodynamics in essential hypertension

By Mashkurova ZT, Sodikova NX, Abdullayeva GJ et al.

Background: Arterial stiffness and central hemodynamic parameters are independent predictors of cardiovascular risk beyond peripheral blood pressure reduction. The comparative impact of different azilsartan-based combinations on structural and pulsatile components of vascular stiffness remains insufficiently explored. Aim: To compare the effects of azilsartan plus nitrendipine (A+N) versus azilsartan plus indapamide (A+I) on carotid–femoral pulse wave velocity (cfPWV), central pulse pressure (cPP), and augmentation index (AIx) in patients with essential hypertension. Methods: In this prospective comparative study, patients with essential hypertension received A+N (n=51) or A+I (n=50) for 6 months. Carotid–femoral PWV and central hemodynamic parameters were assessed at baseline and at 6 months using applanation tonometry. Within-group changes and between-group differences in delta values were analyzed. Results: Both treatment regimens were associated with significant reductions in cfPWV. In the A+N group, PWV decreased from 10.57 m/s to 7.37 m/s (Δ −3.20 m/s; p<0.000001). In the A+I group, PWV decreased from 9.59 m/s to 7.36 m/s (Δ −2.23 m/s; p<0.00001). The between-group difference in PWV reduction was −0.97 m/s in favor of A+N but did not reach statistical significance (p≈0.08). Reduction in central pulse pressure was greater in the A+N group (Δ −21.52 mmHg vs −13.89 mmHg; p≈0.047). No significant between-group differences were observed for changes in AIx. Conclusion: Both azilsartan-based combinations significantly improved arterial stiffness over 6 months. While azilsartan plus nitrendipine showed a numerical trend toward greater PWV reduction and a significantly larger decrease in central pulse pressure, differences in structural stiffness reduction were not statistically significant. These findings suggest broadly comparable effects of the two combinations on vascular stiffness, with a potential differential impact on pulsatile load that warrants further investigation.

doi.org/10.1093/eurheartj/ehag785.3086 Open access Interventions