| Omapatrilat reduces pulse pressure and proximal aortic stiffness in patients with systolic hypertension: results of the conduit hemodynamics of omapatrilat international research study. | |
| | |
MedLine Citation:
|
PMID: 12081987 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Increased pulse pressure, an indicator of conduit vessel stiffness, is a strong independent predictor of cardiovascular events in hypertensive cohorts, which suggests that reduction of conduit vessel stiffness may be desirable in hypertension. METHODS AND RESULTS: We assessed changes in pulse pressure and conduit vessel stiffness in a 12-week double-blind, randomized clinical trial that compared monotherapy with the ACE inhibitor enalapril 40 mg daily (n=87) versus the vasopeptidase (dual ACE and neutral endopeptidase) inhibitor omapatrilat 80 mg daily (n=80) in patients with systolic hypertension. Patients were withdrawn from antihypertensive medications 1 to 2 weeks before enrollment, and systolic pressure was confirmed to be > or =160 mm Hg. With the use of calibrated tonometry and pulsed Doppler, pulsatile hemodynamics were assessed before randomization and at 12 weeks. Characteristic impedance (Z(c)), a direct measure of the stiffness of the central aorta, was calculated from the ratio of changes in carotid pressure and aortic flow in early systole. Omapatrilat compared with enalapril produced greater reductions in peripheral (-8.2+/-12.2 versus -4.0+/-12.2 mm Hg, P<0.05) and central (-10.2+/-16.2 versus -3.2+/-16.9 mm Hg, P<0.01) pulse pressures and Z(c) (237+/-83 to 208+/-70 versus 225+/-87 to 231+/-94 dyne x s/cm(5), P<0.001); the latter remained significant (P<0.05) after adjusting for change in mean pressure. CONCLUSIONS: Greater reductions in pulse pressure and Z(c) in hypertensive subjects treated with omapatrilat compared with enalapril suggest that aortic stiffness is maintained by specific, partially reversible mechanisms and underscore a potential role for pharmacological modulation of natriuretic peptides in the treatment of hypertension. |
| | |
Authors:
|
Gary F Mitchell; Joseph L Izzo; Yves Lacourcière; Jean-Pascal Ouellet; Joel Neutel; Chunlin Qian; Linda J Kerwin; Alan J Block; Marc A Pfeffer |
Related Documents
:
|
17122227 - Arterial versus plethysmographic dynamic indices to test responsiveness for testing flu... 2971067 - The effect of body weight compression on axillo-femoral by-pass patency. 3711577 - The effect of topical 2.5% phenylephrine and 1% tropicamide on systemic blood pressure ... 16459517 - Blood pressure, heart rate and temperature variability during periodontal surgery. 8162507 - Elimination of the influence of intravesical pressure on the micturitional urethral pre... 16942927 - Masked hypertension and target organ damage in treated hypertensive patients. |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Circulation Volume: 105 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2002 Jun |
Date Detail:
|
Created Date: 2002-06-25 Completed Date: 2002-07-08 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
|
Languages: eng Pagination: 2955-61 Citation Subset: AIM; IM |
Affiliation:
|
Cardiovascular Engineering, Inc, Holliston, Mass 01746, USA. GaryFMitchell@mindspring.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Angiotensin-Converting Enzyme Inhibitors / therapeutic use* Antihypertensive Agents / therapeutic use* Aorta / drug effects, physiopathology* Blood Pressure / drug effects Double-Blind Method Enalapril / therapeutic use Female Hemodynamics / drug effects Humans Hypertension / drug therapy*, physiopathology Male Middle Aged Protease Inhibitors / therapeutic use* Pyridines / therapeutic use* Systole Thiazepines / therapeutic use* |
| Chemical | |
Reg. No./Substance:
|
0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Protease Inhibitors; 0/Pyridines; 0/Thiazepines; 0/omapatrilat; 75847-73-3/Enalapril |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coronary pressure measurement after stenting predicts adverse events at follow-up: a multicenter reg...
Next Document: Statin therapy, cardiovascular events, and total mortality in the Heart and Estrogen/Progestin Repla...