Document Detail


Short-term effects of angiotensin receptor blockers on blood pressure control, and plasma inflammatory and fibrinolytic parameters in patients taking angiotensin-converting enzyme inhibitors.
MedLine Citation:
PMID:  18404606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Mehmet Agirbasli; Altug Cincin; Oytun A Baykan
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
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:
Created Date:  2008-04-11     Completed Date:  2008-07-10     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  100971636     Medline TA:  J Renin Angiotensin Aldosterone Syst     Country:  England    
Other Details:
Languages:  eng     Pagination:  22-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey. agirbasil@gmaiol.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin Receptor Antagonists*
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*
Tetrazoles / therapeutic use*
Tissue Plasminogen Activator / immunology*
Chemical
Reg. No./Substance:
0/Angiotensin Receptor Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antigens; 0/Benzimidazoles; 0/Plasminogen Activator Inhibitor 1; 0/Tetrazoles; EC 3.4.17.20/Carboxypeptidase U; EC 3.4.21.68/Tissue Plasminogen Activator; S8Q36MD2XX/candesartan

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


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