| Vascular Effects of ACE Inhibition Independent of the Renin-Angiotensin System in Hypertensive Renovascular Disease : A Randomized, Double-Blind, Crossover Trial. | |
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MedLine Citation:
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PMID: 11208754 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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-To evaluate whether ACE inhibition and angiotensin II type 1 blockade exert beneficial effects on NO availability independent of their blood pressure-lowering effect, we used a double-blind crossover design to study vascular function in 18 patients with hypertensive renovascular disease during 6 weeks of therapy with enalapril (Ena) and valsartan (Val) compared with non-renin-angiotensin system-mediated treatment with the alpha(1)-blocker doxazosin (Dox). Control measurements were performed in 13 age-matched volunteers. Forearm blood flow was assessed with venous occlusion plethysmography, and serotonin and nitroprusside were used as endothelium-dependent and -independent vasodilators, respectively. Blood pressure was similar during all treatment periods. Serotonin-induced vasodilation was decreased in patients during Dox treatment (n=12) compared with control subjects (n=13) (increase 42+/-20% versus 107+/-65%, P:<0.05). Crossover from Dox to Val (n=6) had no effect on serotonin response (increase 50+/-14%), but crossover to Ena (n=6) caused a significant improvement (increase 79+/-39%, P:<0.05 versus Dox). In an assessment of all patients, serotonin-induced vasodilation during Ena (n=12, increase 75+/-31%) was increased compared with both Val and Dox (43+/-14% and 42+/-20%, respectively; both P:<0.05 versus Ena). The nitroprusside response remained unaltered during all treatment periods. In conclusion, ACE inhibition improves the impaired endothelium-dependent vascular function in patients with hypertensive renovascular disease. This effect is unrelated to blood pressure-lowering or angiotensin II-mediated effects. |
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Authors:
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Jacobine M. A. van Ampting; Michel L. Hijmering; Jaap J. Beutler; Ronald E. van Etten; Hein A. Koomans; Ton J. Rabelink; Erik S. G. Stroes |
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Publication Detail:
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Type: JOURNAL ARTICLE |
Journal Detail:
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Title: Hypertension Volume: 37 ISSN: 1524-4563 ISO Abbreviation: Hypertension Publication Date: 2001 Jan |
Date Detail:
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Created Date: 2001-Feb-21 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: - |
Other Details:
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Languages: ENG Pagination: 40-45 Citation Subset: - |
Affiliation:
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Department of Nephrology and Hypertension (J.M.A. van A., J.J.B., H.A.K.), University Medical Center Utrecht, Utrecht, the Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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