Document Detail

Effect of crossing over hypertensive patients from a beta-blocker to an angiotensin receptor antagonist on resistance artery structure and on endothelial function.
MedLine Citation:
PMID:  11791028     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Treatment of essential hypertensive patients with an AT1 angiotensin receptor antagonist has previously resulted in correction of resistance artery structure and endothelial function, whereas in a parallel group treated with the beta-blocker atenolol there was no improvement of altered vascular structure and function. To test the hypothesis that patients previously treated with atenolol could present improvement of vascular structure and endothelial function if they were subjected to blockade of the renin-angiotensin system, we crossed over hypertensive patients that had been randomized to treatment with the beta-blocker atenolol to treatment with the AT1 antagonist irbesartan, and studied small artery structure and endothelial function before and after treatment. METHODS: Eleven essential hypertensive patients (51 +/- 2 years, range 38-65; 75% male) that had previously been randomized to treatment with atenolol and treated for 1 year with good blood pressure control, were crossed over to treatment with the AT1 antagonist irbesartan for 1 year. Small resistance arteries were dissected from gluteal subcutaneous biopsies that were performed before and after 1 year of treatment. The structure and endothelial function of the resistance arteries were studied on a pressurized myograph. RESULTS: Blood pressure control (129 +/- 3.3/85 +/- 1.8 mmHg) was identical to that achieved previously with atenolol (131 +/- 3.3/84 +/- 1.1 mmHg). Following 1 year of treatment, the arterial media width to lumen ratio (M/L) of resistance arteries (lumen diameter, 150-350 microm), which had remained unchanged under atenolol treatment, decreased from 8.44 +/- 0.45% when patients were on atenolol, to 6.46 +/- 0.30%, P < 0.01, when patients received irbesartan. Maximal acetylcholine-induced endothelium-dependent relaxation was 81.1 +/- 4.1% when patients were on atenolol, unchanged from before starting treatment with the beta-blocker, and was normalized by irbesartan (to 94.8 +/- 2.0%, P < 0.01). CONCLUSION: Crossing over essential hypertensive patients with well-controlled blood pressure from the beta-blocker atenolol to the AT1 receptor antagonist irbesartan resulted in correction of previously persistently altered vascular structure and endothelial function, suggesting a structural and endothelial vascular protective effect of antihypertensive treatment with the AT1 receptor antagonist.
Ernesto L Schiffrin; Jeong Bae Park; Qian Pu
Related Documents :
6760678 - Mode of action of beta-adrenoceptor blocking agents in hypertension. a comparison betwe...
22917458 - Impact of paravalvular leakage on outcome in patients after transcatheter aortic valve ...
23403648 - Interleukin-17 expression in murine pressure ulcer tissues.
22390818 - Prediction of arterial pressure increase after fluid challenge.
22245988 - Estimation of central aortic systolic pressure from the second systolic peak of the per...
16180378 - Relationship between socket pressure and emg of two muscles in trans-femoral stumps dur...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  20     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-01-15     Completed Date:  2002-04-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  71-8     Citation Subset:  IM    
Multidisciplinary Research Group on Hypertension, Clinical Research Institute of Montréal, University of Montréal, 110 Pine Avenue West, Montréal, Québec, Canada H2W 1R7.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Acetylcholine / therapeutic use
Adrenergic beta-Antagonists / therapeutic use*
Antihypertensive Agents / therapeutic use
Arteries / drug effects*
Atenolol / therapeutic use
Biphenyl Compounds / antagonists & inhibitors,  therapeutic use
Blood Pressure / drug effects
Cross-Over Studies
Dose-Response Relationship, Drug
Double-Blind Method
Endothelium, Vascular / drug effects*,  physiology*
Heart Rate / drug effects
Hydrochlorothiazide / therapeutic use
Hypertension / complications,  drug therapy*
Hypertrophy, Left Ventricular / complications,  drug therapy,  ultrasonography
Middle Aged
Nitroprusside / therapeutic use
Receptors, Angiotensin / antagonists & inhibitors*,  therapeutic use*
Sensitivity and Specificity
Sodium Chloride Symporter Inhibitors / therapeutic use
Tetrazoles / antagonists & inhibitors,  therapeutic use
Treatment Outcome
Vascular Resistance / drug effects*
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents; 0/Biphenyl Compounds; 0/Diuretics; 0/Receptors, Angiotensin; 0/Sodium Chloride Symporter Inhibitors; 0/Tetrazoles; 138402-11-6/irbesartan; 15078-28-1/Nitroprusside; 29122-68-7/Atenolol; 51-84-3/Acetylcholine; 58-93-5/Hydrochlorothiazide

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

Previous Document:  Intraluminal pressure modulates eicosanoid enzyme expression in vascular endothelium of intact human...
Next Document:  Reduced arterial distensibility is a predictor of cardiovascular disease in patients after renal tra...