Document Detail


Angiotensin receptor blockade improves arterial distensibility and reduces exercise-induced pressor responses in obese hypertensive patients with the metabolic syndrome.
MedLine Citation:
PMID:  15177518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with the metabolic syndrome have three or more of five cardiovascular risk factors and increased oxidative stress, arterial stiffness and pressor responses to exercise, which may contribute to their threefold greater risk for coronary heart disease. In addition to lowering basal blood pressure (BP), angiotensin receptor blockers (ARBs) may benefit metabolic syndrome patients by reducing oxidative stress, arterial stiffness, and pressor responses to exercise. Twelve patients, 7 women and 5 men, with the metabolic syndrome (aged 45 +/- 2 years, BP 145 +/- 5/85 +/- 2 mm Hg, waist girth 110 +/- 3 cm, triglycerides 186 +/- 23 mg/dL, HDL cholesterol 44 +/- 2 mg/dL, glucose 99 +/- 3 mg/dL) were studied off medications, while on modest sodium restriction ( approximately 100 mmol/d). Patients were randomized to the ARB losartan or placebo for 3 weeks then crossed over to the complement for 3 weeks. Studies were performed at the end of each phase following an overnight fast. Serum lipids and biomarkers of oxidative stress (F2-isoprostanes, thiobarbituric acid reacting substances) were unchanged by losartan, whereas large artery elasticity at rest, measured with the HDI PulseWave, increased from 13.6 +/- 0.7 on placebo to 16.2 +/- 1.1 mL/mm Hg on losartan, P <.05. Losartan lowered systolic BP pre-exercise from 142 +/- 3 to 131 +/- 3 mm Hg (P <.001) and systolic BP after 6 min of treadmill exercise from 192 +/- 6 to 169 +/- 5 mm Hg (P <.001). Losartan lowered systolic BP (-23 +/- 3 v -11 +/- 2 mm Hg, P <.05) and pulse pressure (-4 +/- 1 v -15 +/- 2 mm Hg, P <.05) more during exercise than rest. Losartan reduces the pressor response to exercise, perhaps by enhancing arterial compliance. In addition to lowering basal BP, angiotensin receptor blockade in patients with metabolic syndrome improves arterial compliance and reduces pressor reactivity to exercise.
Authors:
Khaled Nashar; Jacqueline P Nguyen; Ammar Jesri; Jason D Morrow; Brent M Egan
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of hypertension     Volume:  17     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-04     Completed Date:  2004-11-06     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  477-82     Citation Subset:  IM    
Affiliation:
Departments of Medicine and Pharmacology, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / therapeutic use
Biological Markers / blood
Blood Pressure / drug effects,  physiology
Cholesterol, HDL / blood
Exercise / physiology*
Female
Heart Atria / drug effects,  physiopathology
Heart Rate / drug effects,  physiology
Humans
Hypertension / drug therapy*,  physiopathology*
Losartan / therapeutic use
Male
Metabolic Syndrome X / drug therapy*,  physiopathology*
Middle Aged
Obesity / drug therapy*,  physiopathology*
Oxidative Stress / drug effects,  physiology
Pressoreceptors / drug effects*,  physiopathology*
Receptors, Angiotensin / antagonists & inhibitors*,  therapeutic use*
Systole / drug effects,  physiology
Treatment Outcome
Grant Support
ID/Acronym/Agency:
CA77839/CA/NCI NIH HHS; DK26657/DK/NIDDK NIH HHS; DK48831/DK/NIDDK NIH HHS; GM42056/GM/NIGMS NIH HHS; HL04290/HL/NHLBI NIH HHS; HL55782/HL/NHLBI NIH HHS; HL58794/HL/NHLBI NIH HHS; RR01070/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Biological Markers; 0/Cholesterol, HDL; 0/Receptors, Angiotensin; 114798-26-4/Losartan

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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