Effect of losartan on ambulatory short-term blood pressure variability and cardiovascular remodeling in hypertensive patients on hemodialysis

Mitsuhashi, Hiroshi; Tamura, Kouichi; Yamauchi, Junji; Ozawa, Motoko; Yanagi, Mai; Dejima, Toru; Wakui, Hiromichi; Masuda, Shinichiro; Azuma, Koichi; Kanaoka, Tomohiko; Ohsawa, Masato; Maeda, Akinobu; Tsurumi‐Ikeya, Yuko; Okano, Yasuko; Ishigami, Tomoaki; Toya, Yoshiyuki; Tokita, Yasuo; Ohnishi, Tsukasa; Umemura, Satoshi

doi:10.1016/j.atherosclerosis.2009.04.005

Cited by 57 publications

(39 citation statements)

References 20 publications

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“…There is a paucity of evidence from humans in this area of research. Increased levels of circulating AGEs have been associated with elevations in systolic blood pressure in people with diabetes [55] and in those with chronic kidney disease on hemodialysis [56][57][58]. Furthermore, administration of AGE crosslink breaker (ALT-711) to patients with hypertension was associated with a concurrent reduction in AGEs, improved endothelial function and reduced arterial stiffness and pulse pressure [29].…”

Section: Discussionmentioning

confidence: 99%

Plasma advanced glycation end products (AGEs) and NF-κB activity are independent determinants of diastolic and pulse pressure

Sourris

Lyons

Dougherty

et al. 2014

Clinical Chemistry and Laboratory Medicine

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Background: High levels of circulating advanced glycation end products (AGEs) can initiate chronic low-grade activation of the immune system (CLAIS) with each of these factors independently associated with cardiovascular (CV) morbidity and mortality. Therefore, our objective was to characterize the relationship between serum AGEs, CLAIS and other risk factors for CV disease in normotensive non-diabetic individuals. Methods: We measured body mass index (BMI), waistto-hip ratio (WHR), blood pressure, lipid and glucose profile in 44 non-diabetic volunteers (17 female, 27 males). Carbo xymethyl-lysine (CML) was measured by ELISA as a marker for circulating AGEs and NF-κB p65 activity as an inflammatory marker by DNA-binding in peripheral blood mononuclear cells lysates (PBMC). Results: Plasma CML concentrations were related to diastolic blood pressure (r = −0.51, p < 0.01) independently of age, sex, BMI and WHR (p < 0.05). Diastolic blood pressure was also related to NF-κB activity in PBMC (r = 0.47, p < 0.01) before and after adjustment for age, sex, BMI and WHR (p < 0.05). Plasma CML concentrations were related to the pulse pressure before (r = 0.42; p < 0.05) and after adjustment for age, sex, BMI and waist (p < 0.05). Neither CML nor NF-κB activity were related to systolic blood pressure (both p = ns). Plasma CML concentrations were not associated with plasma lipid or glucose concentrations (all p = ns). Conclusions: Plasma AGE levels and NF-κB activity in PBMC were independent determinants of diastolic and pulse pressure in healthy normotensive individuals. This association suggests a role for AGEs in the etiology of hypertension, possibly via the initiation of CLAIS and aortic stiffening.

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Section: Discussionmentioning

confidence: 99%

Plasma advanced glycation end products (AGEs) and NF-κB activity are independent determinants of diastolic and pulse pressure

Sourris

Lyons

Dougherty

et al. 2014

Clinical Chemistry and Laboratory Medicine

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show abstract

“…or coefficient of variation in noninvasive ambulatory BP monitoring, is associated with cardiovascular disease. [7][8][9][10][11][12] The circadian pattern of BP in diabetic patients has been found to exhibit a blunted nocturnal decrease in BP, which is associated with autonomic neuropathy and nephropathy. 13,14 The loss of nocturnal BP dipping has been considered to be a risk factor for the progression of nephropathy and to be of prognostic value with respect to target organ damage and cardiovascular morbidity in both diabetic and hypertensive patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of angiotensin II type 1 receptor blocker on ambulatory blood pressure variability in hypertensive patients with overt diabetic nephropathy

et al. 2009

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Previous studies have shown increases in ambulatory short-term blood pressure (BP) variability to be related to cardiovascular disease. In this study, we examined whether the angiotensin II type 1 receptor blocker (ARB) would improve ambulatory shortterm BP variability in hypertensive patients with diabetic nephropathy. A total of 30 patients with type II diabetes, along with hypertension and overt nephropathy, were enrolled in this randomized, two-period, crossover trial of 12 weeks of treatment with losartan (50 mg daily) and telmisartan (40 mg daily). At baseline and at the end of each treatment period, 24-h ambulatory BP monitoring with power spectral analysis of heart rate and measurements of proteinuria, estimated glomerular filtration rate and brachial-ankle pulse wave velocity (baPWV) were performed. After 12 weeks of treatment, 24-h, daytime and nighttime shortterm BP variability, assessed on the basis of the coefficient of variation of ambulatory BP, was significantly decreased by telmisartan. Both losartan and telmisartan reduced urinary protein excretion and baPWV. However, compared with losartan, telmisartan significantly decreased urinary protein excretion, baPWV and low-frequency (LF)-to-high-frequency (HF) ratio, an index of sympathovagal balance. Multiple regression analysis showed significant correlations between urinary protein excretion and baPWV, 24-h LF-to-HF ratio, nighttime systolic BP and 24-h short-term systolic BP variability. These results suggest that ARB, particularly telmisartan, is effective in reducing proteinuria in hypertensive patients with overt diabetic nephropathy, partly through inhibitory effects on ambulatory short-term BP variability and sympathetic nerve activity, in addition to its longer duration of action on nighttime BP reduction.

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“…5,6 Short-term BP variability has also been suggested to be clinically relevant because hypertensive patients with similar mean 24 h BP values exhibit more severe organ damage when their short-term BP variability is greater. [7][8][9][10][11][12][13][14] With respect to home-measured BP, several clinical studies (both long-term followup surveys and cross-sectional studies) have provided an epidemiological basis for supporting the greater accuracy of home BP monitoring than clinic BP measurement for the prognosis of fatal and nonfatal cardiovascular disease (CVD). There is a general consensus that home BP monitoring is more convenient, more readily available and less costly than ambulatory BP monitoring, but ambulatory BP monitoring has been recognized to be superior for certain clinical problems, for example, for the detection of non-dippers or sleep BP in patients with chronic renal disease, autonomic neuropathies or sleep apnea, and for the estimation of short-term BP variability.…”

Section: T He Accumulated Results Of Clinical Trialsmentioning

confidence: 99%

Questionable link between normo- to microalbuminuria and home-measured blood pressure variability in hypertension

Tamura

Shibuya²,

Takeshita

et al. 2012

Hypertens Res

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Effect of losartan on ambulatory short-term blood pressure variability and cardiovascular remodeling in hypertensive patients on hemodialysis

Cited by 57 publications

References 20 publications

Plasma advanced glycation end products (AGEs) and NF-κB activity are independent determinants of diastolic and pulse pressure

Plasma advanced glycation end products (AGEs) and NF-κB activity are independent determinants of diastolic and pulse pressure

Effects of angiotensin II type 1 receptor blocker on ambulatory blood pressure variability in hypertensive patients with overt diabetic nephropathy

Questionable link between normo- to microalbuminuria and home-measured blood pressure variability in hypertension

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