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Effect of losartan on ambulatory short-term blood pressure variability and cardiovascular remodeling in hypertensive patients on hemodialysis.

Abstract：

OBJECTIVE:Previous studies have shown increases in ambulatory short-term blood pressure (BP) variability to be related to cardiovascular disease. In this study, we examined whether an angiotensin II type 1 receptor blocker losartan would improve ambulatory short-term BP variability in hypertensive patients on hemodialysis. METHODS:Forty hypertensive patients on hemodialysis therapy were randomly assigned to the losartan treatment group (n=20) or the control treatment group (n=20). At baseline and 6 and 12 months after the treatment, 24-h ambulatory BP monitoring was performed. Echocardiography and measurements of brachial-ankle pulse wave velocity (baPWV) and biochemical parameters were also performed before and after therapy. RESULTS:After 6- and 12-months of treatment, nighttime short-term BP variability, assessed on the basis of the coefficient of variation of ambulatory BP, was significantly decreased in the losartan group, but remained unchanged in the control group. Compared with the control group, losartan significantly decreased left ventricular mass index (LVMI), baPWV, and the plasma levels of brain natriuretic peptide and advanced glycation end products (AGE). Furthermore, multiple regression analysis showed significant correlations between changes in LVMI and changes in nighttime short-term BP variability, as well as between changes in LVMI and changes in the plasma levels of AGE. CONCLUSION:These results suggest that losartan is beneficial for the suppression of pathological cardiovascular remodeling though its inhibitory effect on ambulatory short-term BP variability during nighttime.

journal_name

Atherosclerosis

journal_title

Atherosclerosis

authors

Mitsuhashi H,Tamura K,Yamauchi J,Ozawa M,Yanagi M,Dejima T,Wakui H,Masuda S,Azuma K,Kanaoka T,Ohsawa M,Maeda A,Tsurumi-Ikeya Y,Okano Y,Ishigami T,Toya Y,Tokita Y,Ohnishi T,Umemura S

doi

10.1016/j.atherosclerosis.2009.04.005

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

186-90

issue

eissn

0021-9150

issn

1879-1484

pii

S0021-9150(09)00270-6

journal_volume

207

pub_type

杂志文章,随机对照试验

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Effect of losartan on ambulatory short-term blood pressure variability and cardiovascular remodeling in hypertensive patients on hemodialysis.