There are no published studies directly comparing the
ability of azilsartan versus candesartan to inhibit binding
of angiotensin II to human AT1
receptors in vitro.
Candesartan is considered to have a very high potency for
binding to human AT1
receptors relative to other ARBs
and is known to be useful in controlling hypertension in
both diabetic and nondiabetic patients.53,54 Some studies
have indicated that the potency of candesartan is relatively
similar to that of azilsartan for inhibiting binding of
angiotensin II to bovine adrenal cortical membranes, blocking
angiotensin II induced contraction of rabbit aorta, and
acutely inhibiting pressor responses to intravenously infused
angiotensin II.38,55 However, it should be noted that usual
oral doses of azilsartan or azilsartan medoxomil yield peak
concentrations of azilsartan in plasma that are 10 to 20 times
greater than the concentrations of candesartan that are
achieved with usual oral doses of candesartan cilexetil.51,56
This may help explain the results of recent studies from
Japan where the maximum approved dose of azilsartan was
found to lower BP significantly more than the maximum
approved dose of candesartan cilexetil