Platelet Aggregability in Patients with Hypertension Treated with Angiotensin II Type 1 Receptor Blockers

Sato, Yuki; Fujii, Satoshi; Imagawa, Shogo; Ohmura, Kazue; Ohmura, Yoshinori; Andoh, Yasuhiro; Dong, Jie; Ishimori, Naoki; Furumoto, Tomoo; Tsutsui, Hiroyuki

doi:10.5551/jat.14.31

Cited by 24 publications

(16 citation statements)

References 24 publications

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“…9 Both telmisartan and losartan have platelet antiaggregatory activity that is not shared by valsartan's, candesartan's, or losartan's major metabolite, EXP3174. [10][11][12][13] Losartan also reduces uric acid, an end-product of purine metabolism linked to the progression of renal disease 14 and increased CV risk 15 and implicated in the development of hypertension in children. 16 It has been hypothesized that these pleiotropic effects of specific ARBs could contribute to the lower incidence of stroke than predicted by BP reduction in outcomes trials of hypertensive patients treated with ARBs compared with treatment with other antihypertensive drugs.…”

Section: Pharmacologic Actions Unique To Specific Arbsmentioning

confidence: 99%

Angiotensin Receptor Blockers: Pharmacology, Efficacy, and Safety

Taylor

Siragy

Nesbitt

2011

The Journal of Clinical Hypertension

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Key Points and Practical Recommendations• The angiotensin receptor blockers are highly effective antihypertensive agents that are also particularly well tolerated.• There are no major differences in efficacy or other clinical characteristics among older drugs in this class, although some of the newer agents may more effectively reduce blood pressure than older agents.• Major randomized clinical trials have demonstrated that angiotensin receptor blockers provide significant outcomes benefits in conditions such as diabetic nephropathy, chronic heart failure or heart failure following myocardial infarction, hypertension with left ventricular hypertrophy and in patients whose histories of previous events or complicated diabetes puts them at high cardiovascular risk.• In treating hypertension, angiotensin receptor blockers can be used as first-line therapy or added at later stages of treatment titration.• These drugs are very effective in combination with thiazide diuretics or calcium channel blockers and there are several single-pill, fixed-dose combinations of angiotensin receptor blockers with hydrochlorothiazide, amlodipine, or aliskiren. These combinations can be given as initial therapy (where appropriate) or later in the course of treatment. Three-drug combinations (angiotensin receptor blocker plus amlodipine plus hydrochlorothiazide and angiotensin receptor blocker plus aliskiren plus hydrochlorothiazide) are also available. J Clin Hypertens (Greenwich). 2011;13:677-686. Ó2011 Wiley Periodicals, Inc.The renin-angiotensin-aldosterone system (RAAS) plays an important role in protecting vertebrates against cardiovascular collapse due to hypotension and volume loss in the event of traumatic injury that involves blood loss. In certain humans, however, inappropriate or exaggerated activity of the RAAS contributes to the development of hypertension and the initiation of a molecular cascade in tissues with consequent injury to critical organs such as the brain, kidneys, heart, and blood vessels. 1-3 As understanding of the pathologic role of the RAAS in hypertensive vascular disease has unfolded during the past century, so has the interest in developing drugs that could interdict specific components of the RAAS. The first of the RAAS-blocking drugs to become commercially available were the aldosterone antagonists in the 1970s, followed by the angiotensin-converting enzyme (ACE) inhibitors in the 1980s and the angiotensin II receptor blockers (ARBs) in the 1990s. Unlike ACE inhibitors that inhibit the conversion of angiotensin I to II, ARBs bind to the angiotensin II AT 1 receptor, thereby inhibiting the cellular actions of angiotension II mediated by the receptor in which the tissue is located. During the past 20 years, studies in the laboratory and clinic have documented that ARBs, either alone or in combination with drugs of other classes, reduce blood pressure (BP) in hypertensive animals and humans; reduce rates of myocardial infarction (MI), stroke, and progression of renal impairment; and positively impact oth...

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Section: Pharmacologic Actions Unique To Specific Arbsmentioning

confidence: 99%

Angiotensin Receptor Blockers: Pharmacology, Efficacy, and Safety

Taylor

Siragy

Nesbitt

2011

The Journal of Clinical Hypertension

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“…PDMPs reportedly play a pivotal role in the acute occlusion of atherosclerotic small arteries or arterioles where pathological levels of fluid shear stress can be found 1,[40][41][42] . Clinically, elevated levels of plasma PDMP are associated with thrombotic disorders 12,18,27,30) .…”

Section: Discussionmentioning

confidence: 99%

Plasma Level of Platelet-Derived Microparticles Is Associated with Coronary Heart Disease Risk Score in Healthy Men

Ueba

Nomura

Inami

et al. 2010

JAT

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Aim:The aim of this study was to clarify the relationship between platelet-derived microparticles (PDMPs) and the Framingham 10-yr coronary heart disease (CHD) risk score. Methods: A cross-sectional study of healthy volunteers free of medication, and cardiovascular or cerebrovascular disease was conducted. The subjects were 190 Japanese men (median age 41). An ELISA kit and monoclonal antibodies against CD42b and CD42a (glycoprotein Ib and IX) were used. Results: PDMPs are correlated with platelet count, high sensitivity C-reactive protein (hsCRP), and diastolic blood pressure by multivariate analysis (R 2 0.316, p 0.001). Quartile range of PDMPs is significantly associated with the 10-yr CHD risk score after adjusting for age, platelet count, hsCRP, and hypertension (p 0.033) and for age, platelet count, hsCRP, and presence of metabolic syndrome (MS) (p 0.020). In individuals with a predicted 10-yr risk for CHD 8% (corresponding with the highest quartile), compared to those with a predicted 10-yr risk 8%, the odds ratio (OR), adjusted for age, platelet count, hsCRP, and hypertension, was 3.3 (1.2 8.9) and adjusted for age, platelet count, hsCRP, and MS, was 4.5 (1.6 11.8). The age-, platelet count-, hsCRP-and hypertensionadjusted OR for a 10-yr CHD risk score 8% was 0.8 (0.5 1.3) for hsCRP and 3.9 (1.6 9.4) for hypertension. The age-, platelet count-, hsCRP-and MS -adjusted OR for a 10-yr CHD risk score 8% was 0.7 (0.4 1.2) for hsCRP and 7.9 (2.6 24.5) for MS. Conclusion: Elevated PDMPs are associated with the 10-yr CHD risk score in healthy men. J Atheroscler Thromb, 2010; 17:342-349.

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“…[3] Most of the clinical events related to hypertension is due to atherosclerosis and thrombosis. [4] Elevated arterial pressure causes pathological changes in vasculature [5] and activated platelets contributes to the vascular damage. This platelet hyperactivity acts as a risk factor in hypertensive patients, causing atherosclerosis and atherothrombosis leading to cardiovascular and cerebrovascular events.…”

Section: Introductionmentioning

confidence: 99%

“…This platelet hyperactivity acts as a risk factor in hypertensive patients, causing atherosclerosis and atherothrombosis leading to cardiovascular and cerebrovascular events. [4] Treatment with antiplatelet agents is a crucial step in preventing thrombotic events. [6] Calcium channel blockers are one among the recommended antihypertensive agents according to 2013 ESH/ESC (European Society of Hypertension and European Society of Cardiology) guidelines, used as either single agent or in combination.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Changes in Bleeding Time in Hypertensive Patients on Amlodipine - A Prospective Observational Study

Kamath¹,

Rudrappa²,

Suresh³

et al. 2016

IJPCS

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Background: Platelet hyperactivity is a risk factor in hypertensive patients that paves the way to atherothrombosis causing cardiovascular and cerebrovascular events. Counteracting platelet aggregation is an established step in preventing thrombotic events. Calcium channel blockers are one among the recommended antihypertensive agents according to 2013 ESH/ESC (European Society of Hypertension and European Society of Cardiology) guidelines. In addition to lowering blood pressure they are known to have antiplatelet activity. Dihydropyridine class of L-type calcium channel blockers are the most potent group and shares this activity. Anti-platelet aggregatory effect of these agents could supplement its anti-hypertensive property and could prove to be desirable in the treatment of hypertensives with high risk of atherosclerotic and thromboembolic risk. So the present study aims to explore the anti-platelet activity of Amlodipine. Objectives: To evaluate the anti-platelet activity of Amlodipine in hypertensive patients. Methods and Materials: Sixty subjects were enrolled in the study. Test group comprised of thirty patients with essential hypertension, who were prescribed Tab Amlodipine at doses 5 mg or 10 mg once daily orally. Patients included in study group were regularly on Amlodipine for at least one month. 30 normotensive subjects, who are not on any drug affecting platelet function like Aspirin, dipyridamole, statins etc. acted as control group.Duke method of Bleeding time estimation was used to assess changes in Bleeding time. Statistical analysis: Student's unpaired t-test was used to compare Amlodipine test group with the normotensive control group. Results were expressed as Mean bleeding time ± SEM. SPSS software version 20 was used for statistical calculations. Results: The mean bleeding time of Amlodipine group was 2.214 minutes ± 0.028 SEM. The control group had a mean bleeding time of 1.998 minutes ± 0.036 SEM. The result gave a statistically significant p value of <0.001. Average duration of treatment was 3.683 years. Conclusion: The statistically significant bleeding time observed in Amlodipine group suggest that it has anti-platelet activity.

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Platelet Aggregability in Patients with Hypertension Treated with Angiotensin II Type 1 Receptor Blockers

Cited by 24 publications

References 24 publications

Angiotensin Receptor Blockers: Pharmacology, Efficacy, and Safety

Angiotensin Receptor Blockers: Pharmacology, Efficacy, and Safety

Plasma Level of Platelet-Derived Microparticles Is Associated with Coronary Heart Disease Risk Score in Healthy Men

Evaluation of Changes in Bleeding Time in Hypertensive Patients on Amlodipine - A Prospective Observational Study

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