Irbesartan, an angiotensin receptor blocker, exhibits metabolic, anti-inflammatory and antioxidative effects in patients with high-risk hypertension

Abstract

Irbesartan, an angiotensin II receptor blocker (ARB), acts as a selective PPAR-γ (peroxisome proliferator-activated receptor-γ) modulator, and thus may have anti-inflammatory and antioxidative effects, as well as beneficial effects on glucose and lipid metabolism. We enrolled 118 high-risk hypertensive outpatients, defined as those with the presence of at least one complication such as coronary artery disease, cerebrovascular disease or diabetes, and who were receiving any ARB except for irbesartan (67±10 years, 80% male subjects). After a 4-week control period, all ARBs were switched to an equivalent dose of irbesartan. We evaluated changes in lipid parameters, inflammatory markers and derivatives of reactive oxygen metabolites (d-ROMs) as an oxidative stress index. After 12 weeks of irbesartan, there were significant decreases in triglycerides (138±73 versus 123±65 mg dl(-1), P<0.05), high-sensitivity C-reactive protein (hs-CRP) (2.80±0.53 versus 2.66±0.50, log (ng ml(-1)), P<0.05) and d-ROMs (338±74 versus 305±62 U.CARR, P<0.001). There were significant increases in high-density lipoprotein cholesterol (50±13 versus 52±14 mg dl(-1), P<0.01) and adiponectin (9.4±6.2 versus 16.6±13.4 ng ml(-1), P<0.05). There were no significant changes in systolic and diastolic blood pressure. The change in d-ROMs from baseline to 12 weeks was positively correlated with the change in hs-CRP (R=0.34, P<0.01). Irbesartan appears to exert beneficial effects on oxidative stress, inflammation, lipid metabolism and metabolic syndrome, indicating that it may be useful in high-risk hypertensive patients.

Effect of growth hormone replacement therapy on plasma diacron-reactive oxygen metabolites and endothelial function in Japanese patients: The GREAT clinical study

“…In addition, the period of improvement of RHI and d-ROMs by reducing some risk factor for the onset of cardiovascular disease (i.e. hypertension, diabetes, dyslipidemia) were generally 3-6 months in another clinical study [14,[16][17]38]. Therefore, we thought 24 weeks after demonstrating the normal range of IGF-1 levels might be adequate to verify the effects of GH replacement therapy.…”

“…In the current study, we assessed oxidative stress using a simple and recently-developed method for evaluating ROMs [17]. This assay is relatively inexpensive, can be performed in minutes, and has been used to assess the effectiveness of various antioxidant treatment strategies [18].…”

Impact of irbesartan, an angiotensin receptor blocker, on uric acid level and oxidative stress in high-risk hypertension patients

“…In this study, we assessed oxidative stress via a simple method for the quantification of ROMs, the dROM test, that we had introduced previously. 17 The dROM test is a photometric method based on the radical reaction of Fenton. The test measures hydroperoxides that are strongly correlated with the amount of ROMs and free radicals.…”

“…17 The aim of this study was to determine whether irbesartan also lowers serum UA level in high-risk hypertension patients in a routine clinical setting.…”

Varenicline-assisted smoking cessation decreases oxidative stress and restores endothelial function

“…The level of d-ROMs was measured by a single technician using a previously reported method. [16][17][18] Briefly, a serum sample and acidic buffered solution (R2 kit reagent, pH 4.8) were mixed in a cuvette, and a chromogenic substrate (R1 kit reagent) was then added to the cuvette. After mixing well, the cuvette was immediately incubated in the thermostatic block of the analyzer for 5 min, and then absorbance at 505 nm was recorded.…”