Document Detail


Fenofibrate lowers blood pressure in salt-sensitive but not salt-resistant hypertension.
MedLine Citation:
PMID:  23385647     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Peroxisome proliferator-activated receptor α agonists reduce blood pressure in rodents, but clinical trials provide conflicting data regarding their effects in humans. We tested the hypothesis that the effect of fenofibrate on blood pressure depends on salt sensitivity.
METHODS: Thirty-one hypertensive volunteers (17 salt-resistant, 14 salt-sensitive) completed a randomized, crossover, double-blind protocol with three dietary phases: low salt diet (10 mmol/day) followed by two consecutive high salt diets (200 mmol/day), each for 6 days. During high salt, volunteers were randomized to fenofibrate 160 mg/day or placebo. Hemodynamic and metabolic parameters were measured on the last morning of each treatment arm.
RESULTS: Fenofibrate reduced triglycerides similarly in salt-sensitive and salt-resistant volunteers. Fenofibrate did not affect blood pressure in salt-resistant volunteers. In salt-sensitive volunteers, fenofibrate significantly decreased diastolic (P = 0.02 versus placebo) and mean arterial (P = 0.04 versus placebo) blood pressure during high salt. In all volunteers, the decrease in systolic pressure during fenofibrate correlated inversely with the salt sensitivity of mean arterial pressure as a continuous variable. Fenofibrate significantly decreased heart rate, plasma renin activity, and renal vascular resistance during high salt in salt-sensitive volunteers, but not salt-resistant volunteers. Fenofibrate did not affect sodium excretion or weight gain during high salt. The effect of salt intake and fenofibrate on plasma and urine epoxyeicosatrienoic acid concentrations differed in salt-resistant and salt-sensitive volunteers.
CONCLUSION: Fenofibrate reduces blood pressure, heart rate and renal vasoconstriction in salt-sensitive volunteers, but not in salt-resistant volunteers. These findings have implications for the treatment of hyperlipidemia in hypertensive individuals.
Authors:
Kimberly Gilbert; Hui Nian; Chang Yu; James M Luther; Nancy J Brown
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  31     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-07     Completed Date:  2013-08-29     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  820-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Antihypertensive Agents / pharmacology,  therapeutic use*
Blood Pressure / drug effects*
Cross-Over Studies
Double-Blind Method
Female
Fenofibrate / pharmacology,  therapeutic use*
Heart Rate / drug effects
Humans
Male
Middle Aged
Sodium Chloride, Dietary / administration & dosage,  adverse effects*
Grant Support
ID/Acronym/Agency:
DK038226/DK/NIDDK NIH HHS; DK081662/DK/NIDDK NIH HHS; HL060906/HL/NHLBI NIH HHS; K23 DK081662/DK/NIDDK NIH HHS; P01 DK038226/DK/NIDDK NIH HHS; R01 DK096994/DK/NIDDK NIH HHS; R01 HL060906/HL/NHLBI NIH HHS; TR000445/TR/NCATS NIH HHS; UL1 TR000445/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Sodium Chloride, Dietary; U202363UOS/Fenofibrate
Comments/Corrections

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


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