| Angiotensin receptor blockade improves arterial distensibility and reduces exercise-induced pressor responses in obese hypertensive patients with the metabolic syndrome. | |
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MedLine Citation:
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PMID: 15177518 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Khaled Nashar; Jacqueline P Nguyen; Ammar Jesri; Jason D Morrow; Brent M Egan |
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Publication Detail:
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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:
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Title: American journal of hypertension Volume: 17 ISSN: 0895-7061 ISO Abbreviation: Am. J. Hypertens. Publication Date: 2004 Jun |
Date Detail:
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Created Date: 2004-06-04 Completed Date: 2004-11-06 Revised Date: 2009-02-24 |
Medline Journal Info:
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Nlm Unique ID: 8803676 Medline TA: Am J Hypertens Country: United States |
Other Details:
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Languages: eng Pagination: 477-82 Citation Subset: IM |
Affiliation:
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Departments of Medicine and Pharmacology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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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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