Abstract:
:The purpose of this double-blind, forced titration study was to compare the antihypertensive effect duration of candesartan cilexetil, which has a longlasting binding to the human AT1-receptor, to that of losartan on ambulatory BP (ABP) not only during the 24-h dosing interval but also during the day of a missed dose intake. After a 4-week placebo lead-in period, 268 patients with sitting diastolic BP 95 to 110 mm Hg and mean awake ambulatory DBP > or =85 mm Hg were randomized to receive either 8 mg of candesartan, 50 mg of losartan, or placebo for a 4-week period. Thereafter, the doses were doubled in all patients for an additional 4-week period. Ambulatory BP monitoring was performed for 36 h after dosing and clinic BP measured 48 h after dosing. Candesartan cilexetil (16 mg) reduced ABP to a significantly greater extent than 100 mg of losartan, particularly for systolic ABP during daytime (P<.05), nighttime (P<.05), and 24-h (P<.01) periods, systolic (P<.01) and diastolic (P<.05) ABP between 0 and 36 h, and both systolic (P<.001) and diastolic (P<0.001) ABP during the day of a missed dose. Clinic BP at 48 h after dosing was significantly reduced exclusively with 16 mg of candesartan. The differences in BP reduction between 8 mg of candesartan and 50 mg of losartan were statistically significant for systolic ABP during daytime (P<.01), nighttime (P<.05), 24-h (P<.01), 0 to 36 h (P<.05) and during the day of missed dose (P<.05). Moreover, although losartan did not significantly reduce ambulatory BP in a dose-related manner, ambulatory systolic and diastolic BP reductions with 16 mg of candesartan were significantly greater (P<.01 and <.001) than those seen with 8 mg of candesartan during every period at the ABP supporting a dose-response relationship. In conclusion, this forced titration study in ambulatory hypertensive patients demonstrates that candesartan cilexetil provides significant dose-dependent reduction in both clinic and ambulatory BP in doses ranging from 8 to 16 mg once daily. Furthermore, candesartan cilexetil is superior to losartan in reducing systolic ABP and in controlling both systolic and diastolic ABP on the day of a missed dose. The differences observed between both agents are most likely attributable to a tighter binding to, and a slower dissociation from, the receptor binding site with candesartan cilexetil.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Lacourcière Y,Asmar Rdoi
10.1016/s0895-7061(99)00142-9subject
Has Abstractpub_date
1999-12-01 00:00:00pages
1181-7issue
12 Pt 1-2eissn
0895-7061issn
1941-7225pii
S0895706199001429journal_volume
12pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Mice with targeted deletion of neuronal nitric oxide (NO) synthase (nNOS⁻(/)⁻) display inability to increase plasma renin concentration (PRC) in response to sodium restriction. nNOS has a distinct expression at the macula densa (MD), and in the present study, it was tested whether nNOS supports renin release...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.153
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Most healthy people exhibit a decrease in systolic blood pressure (SBP) at night. A drop of <10% from mean daytime values, "non-dipping," is associated with kidney disease and cardiovascular events. We hypothesized that non-dipping would predict all-cause mortality. METHODS:Consecutive patients referred for...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2007.7
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Determinants of exercise capacity have not been clearly defined in hypertensive patients. Doppler tissue imaging (DTI), a recently developed echocardiographic modality, is useful for evaluating left ventricular (LV) function regardless of loading conditions. The present study was performed to identify the de...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(03)00842-2
更新日期:2003-07-01 00:00:00
abstract::To evaluate the existence of a relationship between atrial natriuretic factor (ANF) and plasma Na+/K+ATPase inhibitory activity in humans, we examined the hemodynamic and humoral response to volume expansion in 41 borderline hypertensive patients (BHT) with either normal (n = 33) or low plasma renin activity (n = 8). ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.7.618
更新日期:1991-07-01 00:00:00
abstract::Angiotensin-converting enzyme inhibitors (ACEIs), introduced in clinical practice in 1980, are a relatively new class of drugs. They have been useful in the treatment of hypertension, where they are effective monotherapy in 40% to 50% of the patients and in combination therapy in up to 90%. They are also useful in the...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/2.1.57
更新日期:1989-01-01 00:00:00
abstract::Endothelin-1, discovered in 1988, is a 21-amino-acid peptide and currently the most potent vasoconstrictor and pressor substance known. Generated by vascular endothelial cells in response to a variety of chemical and mechanical signals, endothelin-1 is known to potentiate the actions of other vasoconstrictor substance...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(98)00003-x
更新日期:1998-04-01 00:00:00
abstract::We have previously reported that myocardial microsomal Na+,K(+)-ATPase activity, arterial wall ouabain-sensitive 86Rb uptake, and arterial smooth muscle cell membrane potentials are decreased and plasma Na(+)-K+ pump inhibitory activity is increased in rats during the fifth week of one-kidney, one-clip hypertension. W...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::The role of renal sympathetic nerve activity (RSNA) in the maintenance phase of essential hypertension has not yet been clearly defined. Renal function and mean arterial pressure (MAP) were studied in four Yucatan miniature swine (YMS) with established DOCA hypertension prior to and for 3 weeks after surgical renal de...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.1.62
更新日期:1990-01-01 00:00:00
abstract::Plasma renin activity (PRA) declines with age in normal individuals, but the effect of age on plasma angiotensin II (ANG II) is less clear. A decline in plasma ANG II with age could result in altered platelet ANG II receptor density since plasma hormone levels influence their target organ receptors. To investigate thi...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.10.687
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Functional status may be useful for identifying older adults who benefit from lower blood pressure. We examined whether functional status modifies the effect of antihypertensive treatment among older adults. METHODS:Post hoc analyses of the Systolic Hypertension in the Elderly Program (SHEP), a randomized t...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1093/ajh/hpv177
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Both increased night blood pressure (BP) and nondipping are associated with worse cardiovascular risk and prognosis. However, as they are often related features, their relative importance has been difficult to assess separately. In this study we address separate associations of nocturnal hypertension and non...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt175
更新日期:2014-05-01 00:00:00
abstract::Longitudinal studies in children have tracked blood pressure through childhood and from childhood into adult life. However, many children do not maintain their rank during these periods of observation. Several of the factors contributing to maintenance of rank order are reviewed, such as initial level of blood pressur...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/4.11s.608s
更新日期:1991-11-01 00:00:00
abstract::Leptin, the gene product of the ob gene, is influenced by gender and insulin sensitivity. Because in human hypertension there are important endocrine-hemodynamic gender-dependent differences, we compared plasma leptin in 39 essential hypertensives (EH) and in 27 normotensive healthy subjects (HS) matched for gender, a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)00263-6
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:The target levels of home-monitored blood pressure (BP) in patients with type 2 diabetes mellitus (T2DM) have not yet been established. We sought to examine the appropriate target home BP level in T2DM. METHODS:This is a subanalysis of the Japan Morning Surge-Home Blood Pressure (J-HOP) study. We enrolled 4,...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpu249
更新日期:2015-08-01 00:00:00
abstract::The prevalence of left ventricular hypertrophy (LVH) rises with severity of hypertension (HT), age, and obesity. Its prevalence ranges from 20% in mildly hypertensive patients to almost 100% in those with severe or complicated HT. However, the diagnosis of LVH is not straightforward, and the definitions and criteria u...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1038/ajh.2008.16
更新日期:2008-05-01 00:00:00
abstract::To determine if a remodeling of the collagen matrix would occur in the absence of hypertrophy and cell necrosis and if such a remodeling could alter active and passive stiffness of the intact myocardium, five rats with genetic hypertension (SHR) were treated (SHRT) with hydralazine for 32 weeks, beginning at four week...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/2.9.675
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:The elevation of left ventricular filling pressure (LVFP) could be an important prognostic factor in patients with hypertension. We hypothesized that noninvasive brachial-ankle pulse wave velocity (baPWV) is associated with increased LVFP in hypertensive patients with LV hypertrophy (LVH). METHODS:We enroll...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.243
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Increased blood-pressure-variability (BPV) is associated with increased cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus (T2DM). Sodium-glucose-co-transporter-2 (SGLT-2) inhibitors decrease the incidence of cardiovascular events, renal events, and death in this population. Thi...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa207
更新日期:2020-12-05 00:00:00
abstract::This study examined the effects of alterations in salt-intake on blood pressure (BP) in rats chronically treated intravenously with or without the nitric oxide synthase (NOS) inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME) (8.6 mg/kg/day). The changes in mean arterial pressure (MAP), the renal cortical and medul...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02267-1
更新日期:2002-02-01 00:00:00
abstract::Arterial stiffness has been known as a sign of cardiovascular risk since the 19th century. Despite this, accurate measurement and clinical utility have only emerged in recent times. Arterial stiffness and its hemodynamic consequences are now established as predictors of adverse cardiovascular outcome. They are easily ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1038/ajh.2010.192
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:C-reactive protein (CRP) predicts cardiovascular outcome. Oxidative stress is considered to be involved in endothelial alteration. We hypothesized that in essential hypertension (EH), oxidative stress, as measured by 8-iso-prostaglandin-F(2alpha) (8-iso-PGF(2alpha)), should be associated with increased CRP a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.09.005
更新日期:2006-03-01 00:00:00
abstract::A colony of genetic hypertensive dogs with systolic blood pressure of 140 to 220 mm Hg and diastolic blood pressure greater than 100 mm Hg in the trained state was used. The objective of this study was to investigate the hemodynamic and renal effects of the novel angiotensin II receptor antagonist DuP 753 given intrav...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.4.327s
更新日期:1991-04-01 00:00:00
abstract::Since young SHR excrete less urinary kallikrein than WKY, active and total kallikrein (A and T Kall, respectively) was measured (amidolytic assay) in the renal cortex of both strains. Neither at birth nor at age 4 weeks did renal T Kall differ between SHR and WKY. Renal A Kall was significantly lower in newborn SHR an...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/1.3.53s
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:Noninvasive applanation tonometry (APT) is useful to assess aortic stiffness and pulse wave reflection. Moreover, APT can predict outcome in many conditions such as arterial hypertension. In this study, we test whether APT measurements relate to progression of aortic disease in Marfan syndrome (MFS). METHOD...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.115
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:In uremic animals, vitamin D receptor (VDR) agonists like paricalcitol (Pc) attenuate cardiac hypertrophy, but this effect has not been replicated consistently in humans with chronic kidney disease. Elevated fibroblast growth factor 23 (FGF23) levels cause cardiac hypertrophy with activation of the myocardia...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpy154
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The "nondipping" pattern (NDP) of blood pressure, characterized by the absence of the reduction in blood pressure (BP) that typically takes place during the night time, has been associated with elevated cardiovascular morbidity, including stroke, myocardial infarction, and sudden cardiac-related death. In va...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.252
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Hypertension treatment is important in managing chronic renal insufficiency (CRI). Little is known, however, about the blood pressure (BP) control achieved or the pattern of antihypertensive drug prescription among CRI patients. METHODS:Using computerized medical records, we studied 3,089 adult hypertensive...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)02202-6
更新日期:2001-12-01 00:00:00
abstract::The present study evaluates the growth promoting effect of insulin on the proliferative activity of cells from rat mesenteric arteries in culture in order to test the hypothesis that insulin may play a pathogenetic role in the hypertrophy of resistance vessels. The proliferative effect of insulin was studied in cultur...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00324-5
更新日期:1998-01-01 00:00:00
abstract::Cigarette smoking, an established cardiovascular (CV) disease risk factor, is known to impair pulsatile arterial function. However, information is scant in this regard on asymptomatic younger adult former smokers. As part of the Bogalusa Heart Study, the pulsatile arterial function was examined noninvasively in 278 no...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.02.004
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Debate exists about the relationship between hypovitaminosis D and cardiovascular (CVD) risk. METHODS:This study investigated baseline (n=2,271) 25-hydroxyvitamin D (25(OH)D) and baseline and 4 year (n=1,957) CVD risk in a cohort of Finnish middle-aged male smokers. RESULTS:The prevalences of measured hype...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt051
更新日期:2013-08-01 00:00:00