A randomized double blind placebo controlled trial evaluated the effects of 2 doses of azilsartan medoxomil with valsartan 320 mg and olmesartan 40 mg using ambulatory blood pressure BP monitoring and clinic BP measurements. The primary efficacy end point was the change from baseline in 24 hour mean systolic BP. Baseline 24 hour mean systolic BP was 145 mmHg. Azilsartan medoxomil 80 mg had superior efficacy to both valsartan 320 mg and olmesartan 40 mg placebo adjusted 24 hour systolic BP was lowered 14.3 mmHg more than 320 mg of valsartan 10.0 mmHg and 40 mg of olmesartan 11.7 mmHg . Azilsartan medoxomil 40 mg was found to be noninferior to 40 mg olmesartan difference 1.4 mmHg . For clinic systolic BP both doses of azilsartan medoxomil appeared to be superior to the comparator ARBs. Safety and tolerability were similar among the placebo and 4 active treatments. Azilsartan medoxomil at its maximal dose thus demonstrated superior efficacy to both olmesartan and valsartan at their maximal approved doses without increasing adverse events. The findings were published in the journal Hypertension.