Document Detail


Effect of an angiotensin II type 1 receptor blocker, valsartan, on neurohumoral factors in patients with hypertension: comparison with a long-acting calcium channel antagonist, amlodipine.
MedLine Citation:
PMID:  14871033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This study compared the effects of amlodipine and valsartan on the sympathetic nervous system, the renin-angiotensin-aldosterone system, and brain natriuretic peptide, which are considered important parameters of the long-term prognosis. Seventy-three elderly patients, who had received antihypertensive treatment for more than 6 months with amlodipine, participated in this study. They were randomized to the V group (n = 36) and switched to valsartan from amlodipine, or to the A group (n = 37), which continued treatment with amlodipine. The dose of valsartan was set as that which controlled the blood pressure to the same extent as before switching. Blood samples were measured before and after 6 months of therapy. Data were analyzed by two-way analysis of variance with the Newman-Keuls test. In the V group, norepinephrine (from 597.0 +/- 52.9 to 475 +/- 43.8 pg/ml, p < 0.05) and aldosterone (from 74.5 +/- 7.0 to 53.9 +/- 5.3 pg/ml, p < 0.001) were decreased significantly after 6 months, although norepinephrine and aldosterone levels were unchanged in the A group. However, brain natriuretic peptide did not show a difference between the two groups. These findings suggested that valsartan is probably superior to amlodipine with respect to less activation of the sympathetic nervous system and preventing upregulation of the renin-angiotensin-aldosterone system.
Authors:
Yasunori Ohbayashi; Takayoshi Tsutamoto; Tomoko Sakaguchi; Toshinari Tanaka; Toshiyuki Kanamori; Hiroshi Yokohama; Gensyo Sichiri; Daisuke Hukai; Tabito Okabayashi; Tomoya Ozawa; Chitose Ishii; Takashi Tsutsui; Keijin Ohno; Masato Ohnishi; Atsuyuki Wada
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  42 Suppl 1     ISSN:  0160-2446     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2004-02-11     Completed Date:  2004-03-30     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S71-4     Citation Subset:  IM    
Affiliation:
The Department of Cardiology, Nagahama Red Cross Hospital, Nagahama, Japan. yasuoby@ybb.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aldosterone / blood
Amlodipine / administration & dosage,  pharmacokinetics*
Angiotensin II Type 1 Receptor Blockers*
Calcium Channel Blockers / administration & dosage*,  pharmacokinetics
Coronary Disease / complications
Delayed-Action Preparations*
Female
Heart Failure / complications
Humans
Hypertension / complications,  drug therapy*,  physiopathology
Male
Middle Aged
Natriuretic Peptide, Brain / blood
Neurotransmitter Agents / blood,  physiology*
Norepinephrine / blood
Receptor, Angiotensin, Type 1 / physiology*
Tetrazoles / pharmacokinetics*
Time Factors
Valine / analogs & derivatives,  pharmacokinetics*
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Calcium Channel Blockers; 0/Delayed-Action Preparations; 0/Neurotransmitter Agents; 0/Receptor, Angiotensin, Type 1; 0/Tetrazoles; 114471-18-0/Natriuretic Peptide, Brain; 137862-53-4/valsartan; 51-41-2/Norepinephrine; 52-39-1/Aldosterone; 7004-03-7/Valine; 88150-42-9/Amlodipine

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