| Short-term effects of angiotensin receptor blockers on blood pressure control, and plasma inflammatory and fibrinolytic parameters in patients taking angiotensin-converting enzyme inhibitors. | |
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MedLine Citation:
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PMID: 18404606 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Angiotensin-converting enzyme (ACE) inhibitors reduce cardiovascular events in patients with established vascular disease and heart failure (HF). ACE-inhibitors have important effects on fibrinolytic balance, which may be the underlying mechanism for a reduction in cardiovascular events. Although angiotensin-receptor blockers (ARBs) offer greater tolerability than ACE-inhibitors, the major ARB trials have demonstrated a lack of reduction in myocardial infarction (MI) occurrence and mortality in contrast to ACE-inhibitors. In this study, we investigated the combined effects of ARBs and ACE-inhibitors on fibrinolytic and inflammatory parameters in patients with uncontrolled hypertension. METHODS: Twenty-four patients with uncontrolled hypertension despite taking adequate doses of ACE-inhibitor therapy were selected. Patients were started on Candesartan 16 mg once a day. Plasma plasminogen activator inhibitor (PAI-1) antigen (Ag), tissue plasminogen activator (t-PA) Ag, thrombin-activatable fibrinolysis inhibitor (TAFI) % activity and high sensitivity C-reactive protein (hsCRP) levels, were measured during low salt intake at baseline and two weeks after therapy with an ARB. RESULTS: Addition of ARB to the regimen reduced systolic (155+/-17 vs. 139+/-13, p<0.001), and diastolic (91+/-9 vs. 81+/-8, p<0.001) blood pressures (BP). No significant changes were observed in PAI-1 Ag (66+/-51 vs. 68+/-52, p=0.9), t-PA Ag (12.6+/-5.3 vs. 13.3+/-4.7, p=0.3), TAFI % activity (119+/-30 vs. 118+/-32, p=0.9) and hsCRP (3.9+/-3.4 vs. 3.6+/-3.6, p=0.7) levels after adding an ARB. CONCLUSIONS: Combined ARB and ACE-inhibitor use provide better BP control without any detrimental effect in plasma inflammatory and fibrinolytic parameters. |
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Authors:
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Mehmet Agirbasli; Altug Cincin; Oytun A Baykan |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Journal of the renin-angiotensin-aldosterone system : JRAAS Volume: 9 ISSN: 1470-3203 ISO Abbreviation: J Renin Angiotensin Aldosterone Syst Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-04-11 Completed Date: 2008-07-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100971636 Medline TA: J Renin Angiotensin Aldosterone Syst Country: England |
Other Details:
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Languages: eng Pagination: 22-6 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey. agirbasil@gmaiol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angiotensin-Converting Enzyme Inhibitors / adverse effects, pharmacology* Antigens / analysis Benzimidazoles / therapeutic use* Blood Pressure / drug effects* Carboxypeptidase U / blood* Female Humans Male Middle Aged Pilot Projects Plasminogen Activator Inhibitor 1 / immunology* Receptors, Angiotensin / antagonists & inhibitors* Tetrazoles / therapeutic use* Tissue Plasminogen Activator / immunology* |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Antigens; 0/Benzimidazoles; 0/Plasminogen Activator Inhibitor 1; 0/Receptors, Angiotensin; 0/Tetrazoles; 139481-59-7/candesartan; EC 3.4.17.20/Carboxypeptidase U; EC 3.4.21.68/Tissue Plasminogen Activator |
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