Safety and efficacy of antihypertensive therapy with add-on angiotensin II type 1 receptor blocker after successful coronary stent implantation

Abstract

This study was performed to evaluate the safety and efficacy of additional antihypertensive therapy with angiotensin II type 1 receptor blocker (ARB; olmesartan or valsartan) after successful stent implantation in patients with coronary artery disease (CAD). Fifty patients with CAD after successful stent implantation were included in this study. They were divided into an ARB group, which initially received olmesartan (n¼20, 14±8 mg day À1 ) or valsartan (n¼20, 60±23 mg day À1 ) immediately after stent implantation, and a non-ARB group (n¼10) according to their blood pressure (BP). Follow-up coronary angiography, measurement of BP and blood sampling were performed before (at baseline) and 6-8 months after stent implantation (at follow-up). There were no significant differences in the baseline characteristics between the groups, except for BP. Although there were no changes in % diameter restenosis between the groups, the BP level in the ARB group at follow-up showed a significant reduction (125 ± 12/69 ± 9 mm Hg) and reached the target BP. There were no critical adverse effects in the ARB group throughout the study period. In addition, serum high-sensitive C-reactive protein (hs-CRP) and pentraxin 3 were significantly decreased in the ARB group but not in the non-ARB group. Although olmesartan and valsartan induced similar BP-lowering effects, olmesartan but not valsartan induced a significant decrease in hs-CRP, but did not increase serum uric acid. In conclusion, antihypertensive therapy with add-on low-dose ARB after stent implantation was safe and achieved the target BP. In particular, olmesartan had an anti-inflammatory effect.

Olmesartan improves endothelial function in hypertensive patients: link with extracellular superoxide dismutase

“…The present study demonstrated that olmesartan significantly reduced serum hsCRP levels as previously reported. 25,[45][46][47] However, the changes in hsCRP levels were not associated with those in FMD. As in the case of microalbuminuria, as RAS inhibition produces pleiotropic effects, there may not be a simple one-to-one correlation between serum hsCRP levels and endothelial function either.…”

Differential effects of candesartan and olmesartan on adipose tissue activity biomarkers in type II diabetic hypertensive patients

“…The beneficial effects of both olmesartan 24 and candesartan 25 on blood pressure were already known. With regard to the effects of candesartan and olmesartan on adipokines, we know that ADN is a protein exclusively synthesized by adipocytes, which decreases in obese patients and is inversely related to glucose and insulin.…”

The Effects of Antihypertensive Agents in Metabolic Syndrome – Benefits Beyond Blood Pressure Control

“…For instance, in patients with CAD, olmesartan medoxomil and valsartan both produced significant reductions in BP, but only olmesartan medoxomil induced a significant reduction in hsCRP [116]. Losartan has also been shown to reduce hsCRP in newly diagnosed hypertensive patients who are at CV disease risk [117].…”