Effects of one-year treatment with rilmenidine on systemic hypertension-induced left ventricular hypertrophy in hypertensive patients

Trimarco, Bruno; Rosiello, G.; Sarno, Domenico; Lorino, G.; Rubattu, Speranza; DeLuca, N.; Volpe, Massimo

doi:10.1016/0002-9149(94)90040-x

Cited by 13 publications

(10 citation statements)

References 22 publications

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“…However, in the present study the reduction in LVMI did not predict future blood pressure, in accordance with findings in patients with established hypertension. 36 However, given that the values measured were in the high-normal range and that left ventricular hypertrophy is an independent predictor of cardiovascular risk, it cannot be excluded that this effect of candesartan could be advantageous.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker

et al. 2007

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Abstract-Offspring of hypertensive parents are at high risk of future hypertension and subsequent cardiovascular diseases.We investigated whether early treatment with an angiotensin-receptor blocker in young normotensive offspring of hypertensive parents persistently lowered blood pressure after treatment withdrawal, a possibility supported by animal studies. The study is an investigator-initiated, double-blind study of 110 healthy normotensive subjects aged 18 to 36 years where both parents have essential hypertension randomly assigned to 1 of 2 treatment groups: candesartan (Atacand, Astra Zeneca), 16 mg o.d. or placebo. The intervention period was 12 months, with 24 months of follow-up. Primary outcome was mean 24-hour ambulatory blood pressure recordings (mean AMBP) after 12 and 24 months follow-up and was based on intention to treat (nϭ110). Secondary outcomes were changes during treatment in mean AMBP, left ventricular mass, renal hemodynamics, and adverse events during intervention and were based on those completing the intervention period (nϭ105). Primary outcome: At 12 and 24 months follow-up, mean AMBP was not different to placebo. Secondary outcomes: After 12 months of intervention, mean AMBP was reduced: Ϫ3.9/ Ϫ3.4 mm Hg for candesartan versus 0.3/0.6 mm Hg for placebo, PϽ0.0001. Renal vascular resistance and left ventricular mass were also reduced (Pϭ0.0007, Pϭ0.019, respectively). There were no significant differences in adverse advents between the 2 groups. In conclusion, temporary treatment of subjects at high familial risk of future hypertension with an angiotensin receptor blocker is feasible, but the treatment had no persistent effect on blood pressure when treatment was withdrawn. H uman essential hypertension remains the most common risk factor for cardiovascular morbidity and mortality. 1 Preventing or delaying the onset of the disease may therefore have large impact on public health. Such treatment should be directed toward normotensive persons likely to develop hypertension, for which at least 2 major populations can be identified: those who have blood pressures in the upper part of the normotensive range and those who have hypertensive parents. Both these populations have at least a 50% chance of developing hypertension, and each (not mutually exclusive) constitute 10 to 20% of most Western societies. 2 The recently published Trial Of Prevention HYpertension (TROPHY) study 3 has studied this question in the first population, and reported that treatment of subjects with high-normal blood pressure (prehypertensives, eg, blood pressure 130 to 139/85 to 89 mm Hg) with an angiotensin-receptor blocker, candesartan, can delay the onset of hypertension. The result is remarkable, 4 but has also been criticized. 5,6 The present study (Danish Hypertension Prevention Project [DHyPP]) concerns the second population. 7 The study is based on the consistent reports from genetic rat models of essential hypertension that short-term inhibition of the reninangiotensin system has persistent effects on blood ...

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Section: Discussionmentioning

confidence: 99%

Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker

et al. 2007

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“…The safety and efficacy of rilmenidine as a treatment for human hypertension has been demonstrated in clinical trials [43]. It was found to be equally efficacious in elderly hypertensive patients [44] and those who also suffered from diabetes [45], renal impairment [46] or left ventricular hypertrophy [47]. In animal studies, rilmenidine has been shown to increase sodium excretion and urine flow rates [48].…”

Section: Historymentioning

confidence: 99%

“…In animal studies, rilmenidine has been shown to increase sodium excretion and urine flow rates [48]. It is comparable with atenolol [49] and hydrochlorothiazide [47] as a first line antihypertensive. Both rilmenidine and idazoxan, an imidazoline receptor antagonist, have neuroprotective effects in the animal model of ischaemic infarction.…”

Section: Historymentioning

confidence: 99%

Alpha‐2 and imidazoline receptor agonistsTheir pharmacology and therapeutic role

Khan¹,

Ferguson²,

Jones³

1999

Anaesthesia

605

423

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SummaryClonidine has proved to be a clinically useful adjunct in clinical anaesthetic practice as well as in chronic pain therapy because it has both anaesthetic and analgesic-sparing activity. The more selective alpha-2 adrenoceptor agonists, dexmedetomidine and mivazerol, may also have a role in providing haemodynamic stability in patients who are at risk of peri-operative ischaemia. The side-effects of hypotension and bradycardia have limited the routine use of alpha-2 adrenoceptor agonists. Investigations into the molecular pharmacology of alpha-2 adrenoceptors have elucidated their role in the control of wakefulness, blood pressure and antinociception. We discuss the pharmacology of alpha-2 adrenoceptors and their therapeutic role in this review.

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“…Rilmenidine has been proven to be effective in this task when used for a 1-year time interval. 4,5,7) The salutary effects of rilmenidine on left ventricular hypertrophy observed over a time period as long as one year raises questions whether the same effect can be observed when the drug, which is known to be effective in lowering blood pressure in the short term, is given for a 3 month period. The serious problems of timing and cost-effectiveness in the area of initial evaluation and re-assessment of patients with systemic arterial hypertension and LVH exists.…”

Section: Discussionmentioning

confidence: 99%

“…3) In several studies rilmenidine has been shown to reduce left ventricular mass in patients with left ventricular hypertrophy when given on a regular basis for a one year period. 4,5) The efficacy of rilmenidine in lowering blood pressure when given for a four week time period had been demonstrated previously in a study by Ostermann, et al 6) It has been observed that regression of left ventricular hypertrophy takes a long time and depends not only on the drug regimen chosen but also on the duration of treatment. 7) The salutary effects of rilmenidine on left ventricular hypertrophy observed over a time period as long as one year raises the question whether this regression effect can be achieved during a shorter time period in which rilmenidine's antihypertensive effect has already been proven.…”

mentioning

confidence: 84%

<b>Short Term Effects of Rilmenidine on Left Ventricular Hypertrophy and Systolic and Diastolic Function in Patients with Essential Hypertension</b>

2003

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SUMMARYThe short term (three months) effects of rilmenidine on systemic hypertension induced left ventricular hypertrophy (LVH) and left ventricular systolic and diastolic functions in comparison with those of perindopril and nifedipine-slow release (SR) formulation were studied. The short term effects of rilmenidine on biochemical parameters and lipid profiles were evaluated.Sixty patients (39 men, 21 women) with a mean age of 59 ± 14 years and with mild to moderate systemic arterial hypertension were enrolled in three groups. The first group received 1 mg/day of rilmenidine, the second group 4 mg/day of perindopril, and the third group 20 mg/day of nifedipine SR. All drugs induced a similar decrease in systolic and diastolic blood pressure (BP) values. Left ventricular mass (LVM) and LVM index decreased equally in all groups associated with a significant increase in the E/A ratio. The ratio between the reduction in LVM and decrease in mean arterial pressure (LVM/mmHg) was higher in groups 1 and 2. Negative correlations between LVM and LVMI, E/A, and the dv/dt ratio were obtained. Rilmenidine did not change the blood chemistry and lipid profile values.Despite its neutral effect on lipid profile and biochemical parameters, rilmenidine is as effective as perindopril and nifedipine in controlling hypertension and decreasing left ventricular hypertrophy. (

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Effects of one-year treatment with rilmenidine on systemic hypertension-induced left ventricular hypertrophy in hypertensive patients

Cited by 13 publications

References 22 publications

Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker

Treatment of Young Subjects at High Familial Risk of Future Hypertension With an Angiotensin-Receptor Blocker

Alpha‐2 and imidazoline receptor agonistsTheir pharmacology and therapeutic role

<b>Short Term Effects of Rilmenidine on Left Ventricular Hypertrophy and Systolic and Diastolic Function in Patients with Essential Hypertension</b>

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