Aims:  This study intends to compare AZI-M/CT's efficacy and side effect profile to the OLM/HCTZ in hypertensive patients.

Materials and methods: Online databases (PubMed, Google Scholar, and ClinicalTrials.gov) were searched until January 15, 2022, for original articles exploring the effects of AZI-M/CT on pertinent outcomes among hypertensive patients in contrast to OLM/HCTZ. Data on baseline characteristics and endpoints were extracted. Review Manager version 5.4.1 and STATA 16.0 were used for analyses. Risk ratios (RR) and the weighted mean differences (WMD) with corresponding 95% confidence intervals were calculated.

Results: Four studies were included having 3146 patients in total (AZI-M/CT: 1931 and OLM/HCTZ: 1215). The pooled analysis exhibited that compared to OLM-HCTZ, mean DBP was significantly lower in the AZI-M/CT group (WMD –2.64 [-2.78, -2.51]; p= <0.00001, I2= 1%), whereas no significant differences were noted in mean SBP (WMD –2.95 [-6.64,0.73]; p= 0.12, I2=100%) and achievement of target blood pressure (RR 0.95 [0.84,1.07]; p= 0.36, I2= 80%). Additionally, the risk of any TEAE (RR 1.11 [1.03, 1.20]; p= 0.007, I2= 51%) and serious adverse events RR 1.58 [1.20, 2.08]; p= 0.001, I2= 11%) was significantly higher in the AZI-M/CT group. However, no significant differences were observed in the risk of mortality between the two groups (RR 0.74 [0.14, 3.91; p = 0.72, I2= 0%).

Conclusions: Our pooled analysis indicates that AZI-M/CT is more efficient at lowering blood pressure in elderly hypertensive patients than OLM/HCTZ. However, given the limited number of studies, positive results should be discretely re-evaluated and require further research.

 Keywords: Azilsartan-medoxomil; Meta-analysis; Chlorthalidone; AZI-M/CT; Olmesartan-medoxomil; OLM/HCTZ.