Influence of Antihypertensive Treatment with Perindopril, Pindolol or Felodipinon Plasma Leptin Concentration in Patients with Essential Hypertension

Ficek, Joanna; Kokot, F; Chudek, Jerzy; Adamczak, Marcin; Ficek, Rafał; Wiȩcek, Andrzej

doi:10.1055/s-2002-38247

Cited by 15 publications

(12 citation statements)

References 30 publications

(37 reference statements)

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“…In sucrose-fed spontaneously hypertensive rats, Ang II receptor antagonists have been shown to reduce plasma L and L mRNA in adipose tissue (23,34), but data are lacking about the effects of these drugs in humans. In patients with essential hypertension, Ficek et al observed that therapy with the Ang II converting enzyme inhibitor perindopril or the CCB felodipine did not influence leptinemia, whereas the β-blocker pindolol significantly decreased it (24). In the present study, unlike felodipine, valsartan produced a significant reduction in plasma L levels.…”

Section: Discussioncontrasting

confidence: 48%

“…Both dihydropyridine calcium channel blockers (CCBs) and angiotensin (Ang) II type 1 (AT1)-receptor antagonists are suitable for the treatment of obesity-hypertension, since they are devoid of adverse metabolic effects (21). However, contrasting findings have been reported in the literature with regard to their influence on sympathetic activity (22) and few studies have evaluated their effects on plasma L (23,24). With this background, the present study aimed to evaluate the effects of the AT1-receptor antagonist valsartan (25) as compared to the CCB felodipine (26) on plasma L, plasma norepinephrine (NE) and insulin sensitivity in the treatment of hypertensive obese patients.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the Effects of Valsartan and Felodipine on Plasma Leptin and Insulin Sensitivity in Hypertensive Obese Patients

et al. 2005

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Section: Discussioncontrasting

confidence: 48%

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Valsartan and Felodipine on Plasma Leptin and Insulin Sensitivity in Hypertensive Obese Patients

et al. 2005

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“…Certain antihypertensive medications, such as angiotensin receptor blockers, 28 angiotensin-converting enzyme inhibitors 29 and ␤-blockers, 30 have been reported to lower plasma leptin levels. Because antihypertensive medication use was one of the criteria to define hypertension, it is possible that the observed association in our study between leptin and hypertension may be an underestimation of the true association.…”

Section: Discussionmentioning

confidence: 99%

Positive Relationship Between Plasma Leptin Level and Hypertension

Shankar

Xiao

2010

Hypertension

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Abstract-Leptin is an adipose tissue-derived hormone shown to be related to metabolic, inflammatory, and hemostatic factors involved in hypertension development. Animal studies suggest that higher leptin levels may activate the sympathetic nervous system and cause elevations in blood pressure (BP). However, few studies have examined the association between leptin and hypertension in humans. Also it is not clear whether this association is present among women as well as men. Therefore, we examined the association between plasma leptin levels and hypertension in a representative sample of US adults. We examined the third National Health and Nutrition Examination Survey participants Ͼ20 years of age (nϭ5599; 54.7% women). Plasma leptin levels were categorized into quartiles (women: Ͻ7.68, 7.68 to 13.18, 13.19 to 21.70, Ͼ21.70 fg/L; men: Ͻ2.64, 2.64 to 4.36, 4.37 to 7.12, Ͼ7.12 fg/L). Hypertension was defined as BP-reducing medication use or having systolic BP Ն140 mm Hg and/or diastolic BP Ն90 mm Hg. We found that higher plasma leptin levels were positively associated with hypertension after adjusting for age, sex, race/ethnicity, education, smoking, alcohol intake, body mass index, diabetes mellitus, serum cholesterol, and C-reactive protein.Compared with quartile 1 of leptin (referent), the odds ratio (95% CI) of hypertension associated with quartile 4 was 1.89 (1.24 to 2.09; P for trendϭ0.0036). Subgroup analyses examining the relation between leptin and hypertension by sex and body mass index categories also showed a consistent positive association. In conclusion, higher plasma leptin levels are associated with hypertension both among women as well as men in a representative sample of US adults. (Hypertension. 2010;56:623-628.)

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“…However, pindolol markedly suppresses leptin levels without influencing insulin levels. 97 In obese patients with mild to moderate essential hypertension, felodipine has no effect on plasma leptin and insulin sensitivity. However, valsartan significantly reduces plasma leptin, insulin resistance, and BMI.…”

Section: Renin-angiotensin System Blocking Agentsmentioning

confidence: 99%

“…99 Pindolol has a marked suppressive effect on leptin levels. 97 The effects of other drugs in this class on leptin have not yet been investigated.…”

Section: ␤-Blockersmentioning

confidence: 99%

Leptin and Cardiovascular Disease

2008

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L eptin, a 16-kDa hormone identified and cloned in 1994, is synthesized and secreted specifically from white adipose cells. 1 Leptin has a variety of important central and peripheral actions to regulate energy balance and metabolism, fertility, and bone metabolism that are mediated by specific cell surface leptin receptors. 2,3 Importantly, leptin may also exert actions related to cardiovascular homeostasis that are potentially atherogenic, thrombotic, and angiogenic. 4 -6 Leptin has peripheral actions to stimulate vascular inflammation, oxidative stress, and vascular smooth muscle hypertrophy that may contribute to pathogenesis of type 2 diabetes mellitus, hypertension, atherosclerosis, and coronary heart disease. 3,4,7 Insulin resistance, 8 systemic hypertension, and hypercholesterolemia 9 all contribute independently to vascular endothelial dysfunction that promotes atherosclerosis and coronary heart disease. Reciprocal relationships between endothelial dysfunction and insulin resistance are characterized by impaired insulin-stimulated nitric oxide (NO) production from endothelium that decreases blood flow to insulin target tissues. 10,11 Relationships among obesity, metabolic syndrome, diabetes mellitus, and their cardiovascular complications are well established. However, the mechanisms by which excess adiposity causes both insulin resistance and vascular dysfunction are not well understood. Direct vascular effects of adipokines such as leptin are attractive candidates that may help to explain underlying pathophysiological mechanisms.Several clinical studies demonstrate that hyperleptinemia predicts acute cardiovascular events, restenosis after coronary injury such as angioplasty, and cerebral stroke independent of traditional risk factors. 12-14 Leptin-deficient hyperlipidemic mice (ob/ob; apolipoprotein E [apoE] Ϫ/Ϫ mice) develop significantly less atherosclerosis than apoE Ϫ/Ϫ mice on an atherogenic diet. Exogenous leptin significantly increases atherosclerotic areas in apoE Ϫ/Ϫ mice. Taken together, these findings support the notion that leptin accelerates atherosclerosis. 15 By contrast, some data indicate that leptin may protect against atherosclerosis in specific animal models. For example, low-density lipoprotein-receptor knockout mice lacking leptin (LDLR Ϫ/Ϫ ob/ob) develop more atherosclerotic lesions than LDLR Ϫ/Ϫ control mice. 16 Moreover, in 207 women with normal glucose tolerance, impaired glucose tolerance, or type 2 diabetes mellitus, low plasma leptin predicted cardiovascular mortality during a 7-year follow-up period. 17 Thus, the net effects of leptin on cardiovascular pathophysiology are complex and not completely understood.In this review, we discuss cardiovascular actions of leptin related to atherosclerosis, insulin resistance, and hypertension. Particular emphasis is given to insights derived from therapeutic interventions with lifestyle modification, cardiovascular drugs, antidiabetic drugs, and other related treatments. Biology and Metabolism of LeptinThe adipocyte is an active ...

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Influence of Antihypertensive Treatment with Perindopril, Pindolol or Felodipinon Plasma Leptin Concentration in Patients with Essential Hypertension

Abstract: First, patients with essential hypertension are characterized by higher plasma leptin levels as compared with normotensive healthy subjects; second, suppressive effect of pindolol on leptinemia may be of pathophysiological relevance in the course of weight gain during beta-blocker therapy.

Cited by 15 publications

References 30 publications

Comparison of the Effects of Valsartan and Felodipine on Plasma Leptin and Insulin Sensitivity in Hypertensive Obese Patients

Comparison of the Effects of Valsartan and Felodipine on Plasma Leptin and Insulin Sensitivity in Hypertensive Obese Patients

Positive Relationship Between Plasma Leptin Level and Hypertension

Leptin and Cardiovascular Disease

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