| Effects of estradiol and the angiotensin II receptor blocker irbesartan on vascular function in postmenopausal women. | |
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MedLine Citation:
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PMID: 18182939 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Faryal S Mirza; Paul Ong; Peter Collins; Kyoko Okamura; Marie Gerhard-Herman; Gordon H Williams; Ellen W Seely |
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Publication Detail:
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Type: Controlled Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Menopause (New York, N.Y.) Volume: 15 ISSN: 1072-3714 ISO Abbreviation: Menopause Publication Date: 2008 Jan-Feb |
Date Detail:
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Created Date: 2008-01-09 Completed Date: 2008-05-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9433353 Medline TA: Menopause Country: United States |
Other Details:
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Languages: eng Pagination: 44-50 Citation Subset: IM |
Affiliation:
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Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA 02115, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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:
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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:
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Menopause. 2008 Jan-Feb;15(1):9-11
[PMID:
18182938
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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