Angiotensin II type 1 receptor blockade to control blood pressure in postmenopausal women: Influence of hormone replacement therapy

Fernández‐Vega, Francisco; Abellán, José; Vegazo, Onofre; Vinuesa, Soledad García de; Rodríguez, José Carlos; Maceira, B.; Castro, Saturnino Sanz de; Nicolás, Roberto Robles; Luño, José

doi:10.1046/j.1523-1755.62.s82.8.x

Cited by 28 publications

(23 citation statements)

References 20 publications

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“…However, it is tempting to speculate that the balance of the RAS is shifted postmenopause towards the pressor pathway. Certainly, it is known that plasma renin activity is increased in postmenopausal women compared to premenopausal women [36],[37]. Moreover, AT 1 R antagonism improves vascular function in postmenopausal women who are not receiving hormone replacement therapy [38].…”

Section: Discussionmentioning

confidence: 99%

Pressor responsiveness to angiotensin II in female mice is enhanced with age: role of the angiotensin type 2 receptor

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Pressor responsiveness to angiotensin II in female mice is enhanced with age: role of the angiotensin type 2 receptor

et al. 2014

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“…Indeed, 2 recent studies have demonstrated that AT 1 receptor blockade significantly reduces blood pressure in hypertensive postmenopausal women. 43,44 Particularly in light of the disappointing cardioprotective results obtained in several clinical trials with hormone replacement therapy, [45][46][47] the mechanisms underlying the estrogen/Ang II system interaction merit further study for the treatment of hypertension in postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

Postovariectomy Hypertension Is Linked to Increased Renal AT ₁ Receptor and Salt Sensitivity

2003

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Abstract-The functional balance between angiotensin II (Ang II) and nitric oxide (NO) plays a key role in modulating salt sensitivity. Estrogen has been shown to downregulate angiotensin type 1 (AT 1 ) receptor expression and to increase the bioavailability of endothelium-derived NO, which decreases AT 1 receptor expression. The present study tests the hypothesis that in the presence of genetic salt sensitivity, deficiency of endogenous estrogens after ovariectomy (OVX) fosters an upregulation of Ang II. Female Dahl salt-resistant (DR), Dahl salt-sensitive (DS), Wistar-Kyoto (WKY), and spontaneously hypertensive (SHR) rats underwent bilateral OVX or sham surgery (SHX) and were fed a normal salt diet (0.5% NaCl) for 14 weeks. Systolic blood pressures were measured every 2 weeks and were not significantly different between OVX and SHX for DR, WKY, and SHR groups. However, at the end of 14 weeks of normal salt diet, hypertension developed in DS OVX but not SHX rats (160Ϯ3 versus 136Ϯ3 mm Hg; PϽ0.05). Hypertension also developed in DS OVX rats pair-fed a normal salt diet (166Ϯ7 mm Hg). Development of hypertension in DS OVX rats was prevented by estrogen replacement (132Ϯ3 mm Hg), AT 1 receptor blockade (119Ϯ3 mm Hg), or feeding a very low salt diet (0.1% NaCl; 129Ϯ4 mm Hg). Renal AT 1 receptor protein expression was significantly elevated 2-fold in DS OVX relative to SHX rats and was prevented by estrogen replacement. These data strongly suggest that after OVX in salt-sensitive rats there is a lower threshold for the hypertensinogenic effect of salt that is linked to an activation of Ang II. Key Words: rats, Dahl Ⅲ rats, spontaneously hypertensive Ⅲ sodium, dietary Ⅲ angiotensin II Ⅲ estrogen Ⅲ receptors, angiotensin C ardiovascular diseases are the leading cause of death in women and claim the lives of more than half a million women every year. The incidence of cardiovascular disease is 4-fold higher in postmenopausal women than in women of the same age who are premenopausal. 1 Hypertension is a major risk factor for cardiovascular disease. It has been shown that after adjustment for age and body mass index, postmenopausal women are more than twice as likely to be hypertensive as premenopausal women. 2 Thus, after menopause, hypertension may contribute to the increase in cardiovascular risk of postmenopausal women. 3 Accumulating evidence also suggests that postmenopausal women are more salt-sensitive than premenopausal women. 4 A study conducted in postmenopausal Japanese women showed that salt sensitivity correlated inversely with levels of circulating hormones, 5 suggesting that decreases in ovarian hormone levels and increased sensitivity to dietary sodium may be important factors in the genesis of postmenopausal hypertension. Moreover, it has been recently reported that in contrast to women studied during the different phases of the menstrual cycle, menopausal women are characterized by a blunted suppression of renin by salt, which could contribute to the development of salt-sensitive hypertension. 6 These fin...

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“…Conversely, the cause of hypertension is not well defined in postmenopausal women. It is believed that an increased androgen/ estrogen ratio can alter the renin-angiotensin system (31). Other possible causes for hypertension are increased endothelin levels, oxidative stress, obesity and stimulation of the sympathetic nervous system (32).…”

Section: Metabolic Syndrome In Menopausal Womenmentioning

confidence: 99%

Prevalence of metabolic syndrome in pre- and postmenopausal women

Marchi

Dell’Agnolo

Lopes

et al. 2017

Arch. Endocrinol. Metab.

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Objective: The objective of this study was to determine the prevalence of metabolic syndrome (MS) and its components among pre-and postmenopausal women, as well as the association between menopausal status and MS. Materials and methods: A retrospective study was conducted at a reference cardiology outpatient clinic in a city located in Northwestern Paraná State, Brazil. A total of 958 medical records of symptomatic climacteric women evaluated between 2010 and 2014 were analyzed. The study consisted of two groups: pre-and post-menopausal women. MS was characterized according to the criteria of the National Cholesterol Education Program's Adult Treatment Panel III -NCEP-ATP III-2005. Results: MS was observed in 18.5% of the total study population; 9.4% of the premenopausal women and 22.2% of the postmenopausal women displayed MS, corresponding to a relative risk of 2.75. In addition, the frequency of MS increased with age. Regarding the components of MS, postmenopausal women were more likely to have high density lipoprotein (HDL-C) levels < 50 mg/dL; systolic blood pressure (SBP) values ≥ 130 mmHg or diastolic blood pressure (DBP) values ≥ 85 mmHg; and fasting glucose levels ≥ 100 mg/dL. Conclusion: MS was more prevalent among postmenopausal women than among premenopausal women. Arch Endocrinol Metab. 2017;61(2):160-6.

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Angiotensin II type 1 receptor blockade to control blood pressure in postmenopausal women: Influence of hormone replacement therapy

Abstract: Candesartan cilexetil significantly reduced SBP and DBP and increased control (61.2%) of BP in hypertensive menopausal women. Only age had an inverse association with control of BP. In this study, HRT did not affect the control of BP.

Cited by 28 publications

References 20 publications

Pressor responsiveness to angiotensin II in female mice is enhanced with age: role of the angiotensin type 2 receptor

Pressor responsiveness to angiotensin II in female mice is enhanced with age: role of the angiotensin type 2 receptor

Postovariectomy Hypertension Is Linked to Increased Renal AT ₁ Receptor and Salt Sensitivity

Prevalence of metabolic syndrome in pre- and postmenopausal women

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Angiotensin II type 1 receptor blockade to control blood pressure in postmenopausal women: Influence of hormone replacement therapy

Abstract: Candesartan cilexetil significantly reduced SBP and DBP and increased control (61.2%) of BP in hypertensive menopausal women. Only age had an inverse association with control of BP. In this study, HRT did not affect the control of BP.

Cited by 28 publications

References 20 publications

Pressor responsiveness to angiotensin II in female mice is enhanced with age: role of the angiotensin type 2 receptor

Pressor responsiveness to angiotensin II in female mice is enhanced with age: role of the angiotensin type 2 receptor

Postovariectomy Hypertension Is Linked to Increased Renal AT 1 Receptor and Salt Sensitivity

Prevalence of metabolic syndrome in pre- and postmenopausal women

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Resources

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Postovariectomy Hypertension Is Linked to Increased Renal AT ₁ Receptor and Salt Sensitivity