| ANGIOTENSIN RECEPTOR BLOCKERS SHIFT THE CIRCADIAN RHYTHM OF BLOOD PRESSURE BY SUPPRESSING TUBULAR SODIUM REABSORPTION. | |
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MedLine Citation:
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PMID: 21865265 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Recently, we found that an angiotensin II receptor blocker (ARB) restored the circadian rhythm of the blood pressure (BP) from a non-dipper to dipper pattern, similar to that achieved with sodium intake restriction and diuretics. ARB enhanced natriuresis during the day, while BP was markedly lower during the night, resulting in the dipper pattern. In the present study, we examined whether or not the suppression of tubular sodium reabsorption, similar to the action of diuretics, was the mechanism by which ARB normalized the circadian BP rhythm. BP and glomerulo-tubular balance was compared in 41 patients with chronic kidney disease before and during ARB treatment with olmesartan once a day in the morning for 8 weeks. ARB increased natriuresis (U(Na)V) during the day (4.5±2.2 to 5.5±2.1 mmol/hr, p=0.002), while had no effect during the night (4.3±2.0 to 3.8±1.6 mmol/hr, p=0.1). The night/day ratios of both BP and U(Na)V were decreased. The decrease in the night/day ratio of BP correlated with the increase in daytime U(Na)V (r=0.42, p=0.006). Throughout the whole day, glomerular filtration rate (p=0.0006) and tubular sodium reabsorption (p=0.0005) were both reduced significantly by ARB, although U(Na)V remained constant (107±45 vs. 118±36 mmol/day, p = 0.07). These findings indicate that the suppression of tubular sodium reabsorption, showing resemblance to the action of diuretics, is the primary mechanism by which ARB can shift the circadian BP rhythm into a dipper pattern. |
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Authors:
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Michio Fukuda; Tamaki Wakamatsu-Yamanaka; Masashi Mizuno; Toshiyuki Miura; Tatsuya Tomonari; Yoko Kato; Tadashi Ichikawa; Sota Miyagi; Yuichi Shirasawa; Akinori Ito; Atsuhiro Yoshida; Genjiro Kimura |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-24 |
Journal Detail:
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Title: American journal of physiology. Renal physiology Volume: - ISSN: 1522-1466 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-25 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100901990 Medline TA: Am J Physiol Renal Physiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Nagoy City University Graduate School of Medical Sciences. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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