Document Detail


Effect of angiotensin II type 1 receptor blocker, candesartan, and beta 1 adrenoceptor blocker, atenolol, on brain damage in ischemic stroke.
MedLine Citation:
PMID:  20511125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This work aims at studying the possible alteration of renal renin secretion after human ischemic stroke and correlating it to the post stroke neurological and renal function alterations using angiotensin II type 1(AT1) receptor blocker (ARB), candesartan, and beta 1 adrenoreceptor blocker atenolol, which inhibits renin secretion, in Wistar rats subjected to middle cerebral artery occlusion. Methods . This study comprised 21 patients with cerebral ischemic stroke. Seventeen normal persons were used for comparison. Recumbent and standing plasma renin activity (PRA), reflex plasma renin sensitivity, plasminogen activator inhibitor and creatinine clearance (Ccr) were estimated at admission and two weeks later. Moreover, 60 male Wistar rats were divided into two groups SHAM and ischemic. Each of the two groups was further subdivided into three subgroups, non-treated, atenolol treated, and candesartan treated. In all rats, mean arterial blood pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), heart rate (HR), neurobehavioral evaluation, Ccr, PRA, and infarct size were measured. Results . Together with the significant deterioration of the neurological score, focal cerebral ischemia in rats resulted in increased PRA and decreased glomerular filtration rate (GFR). In ischemic stroke patients, GFR was significantly decreased at admission and two weeks later, PRA increased at admission and two weeks later while plasma renin reflex secretion sensitivity had decreased significantly at admission relative to controls, but it increased significantly 2 weeks later. Atenolol caused significant improvement of the neurobehavioral score and renal function and decrease infarct size of rats subjected to focal cerebral ischemia whereas candesartan caused significant improvement of the neurobehavioral score and decreased infarct size with no significant change in GFR. Neither atenolol nor candesartan caused significant change in MAP, SBP, DBP, PP and HR Conclusion . (1) Ischemic stroke seems to be associated with a postischemic increase of the plasma renin secretion, which may increase the infarct size in the brain and may induce acute renal insufficiency. (2) This study confirms that Atenolol and ARBs could benefit ischemic stroke patients without altering blood pressure.
Authors:
M Ahdy A Saad; Amr M Abbas; V Boshra; M Elkhateeb; I Abd El Aal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta physiologica Hungarica     Volume:  97     ISSN:  0231-424X     ISO Abbreviation:  Acta Physiol Hung     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-31     Completed Date:  2010-07-06     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  8309201     Medline TA:  Acta Physiol Hung     Country:  Hungary    
Other Details:
Languages:  eng     Pagination:  159-71     Citation Subset:  IM    
Affiliation:
Department of Pharmacology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-1 Receptor Antagonists*
Adrenergic beta-Antagonists / pharmacology*
Angiotensin II Type 1 Receptor Blockers / pharmacology*
Animals
Atenolol / pharmacology*
Behavior, Animal / drug effects
Benzimidazoles / pharmacology*
Biological Markers / blood
Brain Ischemia / blood,  complications,  drug therapy*,  physiopathology
Case-Control Studies
Creatinine / blood
Disease Models, Animal
Glomerular Filtration Rate / drug effects
Hemodynamics / drug effects
Humans
Hypoxia, Brain / blood,  etiology,  physiopathology,  prevention & control*
Kidney / drug effects*,  metabolism,  physiopathology
Male
Plasminogen Inactivators / blood
Rats
Rats, Wistar
Renin / blood
Renin-Angiotensin System / drug effects
Stroke / blood,  drug therapy*,  etiology,  physiopathology
Tetrazoles / pharmacology*
Time Factors
Chemical
Reg. No./Substance:
0/Adrenergic beta-1 Receptor Antagonists; 0/Adrenergic beta-Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Benzimidazoles; 0/Biological Markers; 0/Plasminogen Inactivators; 0/Tetrazoles; 29122-68-7/Atenolol; 60-27-5/Creatinine; EC 3.4.23.15/Renin; S8Q36MD2XX/candesartan

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