Document Detail


Effects of estradiol and the angiotensin II receptor blocker irbesartan on vascular function in postmenopausal women.
MedLine Citation:
PMID:  18182939     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Estradiol and angiotensin receptor blockers have prominent effects on the renin-angiotensin-aldosterone system. The purpose of this study was to determine whether irbesartan, an angiotensin receptor blocker, has a greater effect on vascular function when combined with estradiol, compared with irbesartan alone, in hypertensive postmenopausal women. DESIGN: Fifty-one women were studied while off any antihypertensive medications or hormone therapy at baseline and after randomization to one of four treatment arms for 12 weeks: (1) irbesartan and estradiol, (2) irbesartan and placebo, (3) estradiol and placebo, and (4) placebo/placebo. Estradiol and placebo arms served as control groups. Blood pressure, brachial reactivity, aldosterone, insulin, glucose, 24-hour urinary catecholamines, urinary sodium, and creatinine were measured. Fisher's exact test was used for comparison of differences in blood pressure in the treatment arms. Paired t test and analysis of variance were also performed for within- and between-group analysis. RESULTS: A significantly larger number of women in the irbesartan and estradiol group had a decrease of 5 mm Hg or more in both systolic and diastolic blood pressures (P < 0.05) compared with irbesartan alone group. Forearm vascular reactivity was increased significantly compared with baseline (P < 0.05), and there was a significant decrease in the serum aldosterone level after treatment compared with baseline (P < 0.05) in the irbesartan and estradiol combination group. Fasting glucose and insulin, urinary sodium/creatinine ratio, and catecholamines were similar at each time point. CONCLUSIONS: The results suggest that irbesartan and estradiol, when used in combination, may cause a greater lowering of blood pressure in postmenopausal hypertensive women. This effect may be mediated via increased vasodilation and lower aldosterone levels. These results warrant further testing in larger clinical trials.
Authors:
Faryal S Mirza; Paul Ong; Peter Collins; Kyoko Okamura; Marie Gerhard-Herman; Gordon H Williams; Ellen W Seely
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Menopause (New York, N.Y.)     Volume:  15     ISSN:  1072-3714     ISO Abbreviation:  Menopause     Publication Date:    2008 Jan-Feb
Date Detail:
Created Date:  2008-01-09     Completed Date:  2008-05-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9433353     Medline TA:  Menopause     Country:  United States    
Other Details:
Languages:  eng     Pagination:  44-50     Citation Subset:  IM    
Affiliation:
Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aldosterone / blood
Angiotensin II Type 1 Receptor Blockers / administration & dosage*
Antihypertensive Agents / administration & dosage*
Biphenyl Compounds / administration & dosage*
Blood Glucose / metabolism
Catecholamines / urine
Creatinine / urine
Dose-Response Relationship, Drug
Drug Therapy, Combination
Estradiol / administration & dosage*
Female
Humans
Hypertension / drug therapy*
Insulin / blood
Middle Aged
Postmenopause / drug effects*
Sodium / urine
Tetrazoles / administration & dosage*
Treatment Outcome
Vasodilation / drug effects*
Women's Health
Grant Support
ID/Acronym/Agency:
HL55000/HL/NHLBI NIH HHS; HL67332/HL/NHLBI NIH HHS; K24 RR018613/RR/NCRR NIH HHS; R01 RR002635/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Biphenyl Compounds; 0/Blood Glucose; 0/Catecholamines; 0/Tetrazoles; 11061-68-0/Insulin; 138402-11-6/irbesartan; 50-28-2/Estradiol; 52-39-1/Aldosterone; 60-27-5/Creatinine; 7440-23-5/Sodium
Comments/Corrections
Comment In:
Menopause. 2008 Jan-Feb;15(1):9-11   [PMID:  18182938 ]

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


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