Abstract:
BACKGROUND:Recent reports suggest that existing antihypertensive agents may not have sufficient efficacy to control blood pressure (BP) in many patients. Omapatrilat, an agent under development, has been shown to have significantly greater antihypertensive efficacy than existing agents, but may also carry increased risk of angioedema. We compared the efficacy and safety of omapatrilat to a representative angiotensin-converting enzyme (ACE) inhibitor, enalapril. METHODS:The Omapatrilat Cardiovascular Treatment vs. Enalapril (OCTAVE) trial is a multicenter, randomized, double-blind, active-controlled, 24-week trial in 25,302 patients with untreated or uncontrolled hypertension conducted in 3298 office-based sites in 12 countries. Subjects were randomized to omapatrilat 10 mg or enalapril 5 mg as initial therapy for hypertension (group 1, n = 9292), replacement for existing antihypertensive therapy (group 2, n =11,224), or in addition to existing antihypertensive therapy (group 3, n = 4751). Study drug was force-titrated at week 2 and electively titrated at weeks 4 and 6 to a maximum of omapatrilat 80 mg or enalapril 40 mg once daily. At weeks 8 and 16, adjunctive antihypertensive medications were added electively to achieve target BP. RESULTS:Omapatrilat reduced systolic BP 3.6 mm Hg more than enalapril at week 8, and was associated with less use of adjunctive antihypertensive therapy by week 24 (19% v 27%; P < 0.001 for both comparisons). Subjects randomized to omapatrilat were more likely to reach BP target, regardless of demographics or comorbid conditions and whether omapatrilat was used as initial therapy, replacement for existing therapy, or in addition to existing therapy. Angioedema was more frequent with omapatrilat than enalapril (2.17% v 0.68%). Two omapatrilat-treated subjects experienced angioedema with airway compromise, which was successfully treated. CONCLUSIONS:Omapatrilat provided broadly superior antihypertensive efficacy when used in a setting resembling clinical practice. Angioedema was more common than with enalapril but life-threatening angioedema was rare. The risk-benefit profile for omapatrilat in clinical use therefore appears likely to be favorable in appropriate patients.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Kostis JB,Packer M,Black HR,Schmieder R,Henry D,Levy Edoi
10.1016/j.amjhyper.2003.09.014subject
Has Abstractpub_date
2004-02-01 00:00:00pages
103-11issue
2eissn
0895-7061issn
1941-7225pii
S0895706103011701journal_volume
17pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:The ratio of urinary concentrations of tetrahydrocortisol plus allotetrahydrocortisol to tetrahydrocortisone [(THF + ATHF)/THE] reflects the activity of the enzyme 11beta-hydroxysteroid dehydrogenase type 2 (11BHSD2), which converts cortisol to cortisone in the kidney and thereby protects the mineralocortico...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(03)00981-6
更新日期:2003-09-01 00:00:00
abstract::The aim of this study was to compare the efficacy (lowering diastolic blood pressure to 90 mm Hg or less) of urapidil, a postsynaptic alpha-blocker with central action with that of captopril in a randomized, double-blind, multicenter study. Two hundred ninety-five essential hypertensives (WHO I/II) (140 male, 155 fema...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ajh/1.3.233s
更新日期:1988-07-01 00:00:00
abstract::A prospective randomized, double-blind, double-dummy study investigated the effects of two angiotensin converting enzyme (ACE) inhibitors on urinary albumin excretion in nondiabetic patients with mild to moderate essential hypertension. At the end of a 4-week placebo run-in period, 36 patients were randomly allocated ...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/ajh/7.1.46
更新日期:1994-01-01 00:00:00
abstract::To investigate the possibility that seasonal adaptation requires significant hemodynamic changes, 5 normotensive and 21 mildly hypertensive subjects were followed through 4 seasons for changes in systemic hemodynamics and sympathetic nervous activity. In the upright position wintertime blood pressures increased by 3% ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.5.405
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Obesity is one of the main determinants of blood pressure. The aim of this study was to evaluate and quantify the relations between the different anthropometric indices and blood pressure (BP) stratified by gender. METHODS:Cross-sectional analyses were performed using data from 2,105 adults from the ESTEBAN...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpz096
更新日期:2019-09-24 00:00:00
abstract:BACKGROUND:Few population studies have described the heritability and intrafamilial concordance of the retinal microvessels, or the genetic or environmental correlations of the phenotypes of these vessels. METHODS:We randomly selected 413 participants from 70 families (mean age, 51.5 years; 50.1% women) from a Flemish...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hps064
更新日期:2013-03-01 00:00:00
abstract::We studied the role of the sympathetic nervous system and the renin angiotensin system for pressure induced left ventricular hypertrophy (LVH) in 135 rats with experimental supravalvular aortic stenosis (AS). We induced this condition by a silver clip on the ascending aorta, when body weight (BW) was 90 to 100 g. Symp...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.6.521
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:The genetic component related to blood pressure (BP) changes during pregnancy is still not elucidated. Thus, the aim of the study was to evaluate the association between leptin and leptin receptor polymorphisms and systolic (SBP) and diastolic BP (DBP) variation during pregnancy and the postpartum period. M...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpw147
更新日期:2017-02-01 00:00:00
abstract::Preeclampsia is a pregnancy-induced hypertensive disorder characterized by proteinuria and widespread maternal endothelial dysfunction. It remains one of the most common disorders in pregnancy and remains one of the leading causes of maternal and fetal morbidity. Recent research has revealed that placental insufficien...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1038/ajh.2011.99
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Left ventricular (LV) hypertrophy and impaired diastolic function may occur early in systemic hypertension, but longitudinal studies are missing. METHODS:We performed an echocardiographic follow-up study in young initially normotensive male offspring of hypertensive (OHyp) (n = 25) and normotensive (ONorm) ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(00)01245-0
更新日期:2001-02-01 00:00:00
abstract::This study found that pigs in the early stages of perinephritic hypertension had enhanced plasma norepinephrine (NE) and heart rate (HR) responses to behaviorally arousing stimuli (lifting in a canvas sling) and exercise. In the hypertensive animals, the increase in plasma NE in response to behavioral arousal caused b...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.10.844
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Few previous studies have reported the association of aortic stiffness with marine n-3 fatty acids (Fas) in the general population. The aim of this study was to determine the combined and independent associations of 2 major marine n-3 FAs, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with aort...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt107
更新日期:2013-11-01 00:00:00
abstract::A wide pulse pressure (PP) may constitute an independent predictor of cardiovascular morbidity and mortality. We assessed the reference values of brachial clinic PP, according to age and gender in a nonselected population (61,724 subjects) who were undergoing a routine systematic health examination. According to mean ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(01)01284-5
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Recent studies have shown that hyperuricemia may be associated with incident hypertension (HTN). We examined whether serum uric acid (SUA) is a predictor of HTN and target organ damage (TOD) 20 years later in initially healthy middle-aged individuals. METHODS:Participants from the Suivi Temporaire Annuel No...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa030
更新日期:2020-09-10 00:00:00
abstract:BACKGROUND:Microalbuminuria is recognized as a marker of generalized vascular dysfunction. However, the associations between microalbuminuria and pulse wave velocity (PWV), carotid intima-media thickness (IMT), and ambulatory blood pressure (ABP), respectively, have not been investigated. METHODS:Brachial-ankle PWV (b...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2007.77
更新日期:2008-04-01 00:00:00
abstract::Great pathophysiological significance has recently been placed on the association of metabolic abnormalities, such as hyperinsulinemia, insulin resistance, obesity, and frank diabetes mellitus, with essential hypertension and coronary artery disease, and the clinical coincidence of these features has been termed "synd...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1093/ajh/6.4s.123s
更新日期:1993-04-01 00:00:00
abstract::In the present study, age- and calcium-related changes in the membrane fluidity of erythrocytes were examined in patients with essential hypertension by use of electron spin resonance method (ESR). The erythrocytes were obtained from patients with essential hypertension. We examined the ESR spectra for a fatty acid sp...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/3.9.714
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:During the development of hypertension, glucose replaces triacylglycerols (TG) as the main energy source for the myocardium. However, there are no available studies investigating the TG molecular species composition of the myocardium in the spontaneously hypertensive rat (SHR). The objective of this study wa...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.11.012
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Coffee is a rich source of antioxidative polyphenols, but epidemiological studies and interventional trials have failed to demonstrate any clear beneficial effects of coffee consumption on hypertension. The interaction between hydroxyhydroquinone (HHQ) and 5-caffeoylquinic acid (CQA) was examined, in an atte...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2007.3
更新日期:2008-01-01 00:00:00
abstract::Ca2+ efflux from cultured vascular smooth muscle cells (VSMC) consists of two mechanisms: one is dependent on extracellular sodium, mediated by the Na(+)-Ca2+ exchange (Na+o-dependent Ca2+ efflux), and the other is independent of extracellular sodium but is mediated by the Ca(2+)-pump (Na+o-independent Ca2+ efflux). I...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/7.7.597
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Left ventricular (LV) concentric geometry and hypertrophy, depressed wall mechanics, and abnormal diastolic properties have been described in the diabetic heart. However, the cardiac response to dynamic exercise in diabetic patients remains controversial. The present study assessed strain rate (SR) imaging d...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2006.12.009
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:An increasing number of arterial function assessments are available, including small and large arterial elasticity (SAE/C2, LAE/C1), endothelial function as measured by flow mediated dilation (FMD), carotid intima-medial thickness (IMT), ankle brachial index (ABI), pulse pressure (PP), and pulse wave velocit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2003.10.009
更新日期:2004-04-01 00:00:00
abstract::Conflicting reports exist as to whether air traffic controllers (ATC) have an increase in blood pressure (BP) and prevalence of hypertension because of the stressful nature of their job. We have addressed the issue in male ATC working at the Linate airport of Milan. A total of 80 ATC participated, and the 24 h blood p...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00321-x
更新日期:1998-02-01 00:00:00
abstract::Evidence is presented that bradykinin inhibits norepinephrine efflux from sympathetic nerves innervating canine mesenteric and pulmonary arteries, in part, by releasing endothelium-derived relaxing factor (EDRF) from the vascular endothelium. Moreover, in the absence of vascular endothelium, bradykinin also inhibits n...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.5.464
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Insulin resistance (IR) and the metabolic syndrome (MetS) may contribute to cardiovascular risk in chronic kidney disease (CKD). We examine the association between IR and vascular function in CKD. Furthermore, we define the prevalence of MetS and examine the association between defining MetS and vascular fun...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpt077
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Subjects with renovascular hypertension (RVH) often manifest with metabolic syndrome (MetS) as well. Coexisting MetS and hypertension increases cardiovascular morbidity and mortality, but the mechanisms underlying cardiac injury remain unknown. We hypothesized that superimposition of MetS induces myocardial ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hpaa202
更新日期:2020-12-05 00:00:00
abstract::The aim of this study was to assess whether an interaction exists between the renin-angiotensin system and the sympathetic nervous system at the level of the adrenal medulla during insulin-induced hypoglycemia in normal humans. Seventeen healthy volunteers were studied in a randomized, single-dose, double-blind, cross...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ajh/5.6.361
更新日期:1992-06-01 00:00:00
abstract::The principal aim of the present study was to determine the relationship of ambulatory blood pressure (BP) to urinary electrolyte excretion in normotensives. Twenty-five young adults underwent ambulatory BP and heart rate monitoring while collecting urine over 24 h. The correlations of 24 h urine sodium excretion and ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.6.480
更新日期:1993-06-01 00:00:00
abstract::The present study was designed to investigate the role of the autonomic nervous system in experimental hypertension induced by chronic administration of N-nitro-L-arginine methyl ester (L-NAME) in the drinking water (1 mg/mL) over 6 days. L-NAME ingestion caused a large rise in resting mean arterial pressure (MAP) (17...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/6.9.806
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) and hypertension (HT) frequently coexist. Increased central aortic pressures indexes are associated with HT; however, possible associations of these indexes with future development of DM have never been studied in HT. METHODS:We recruited 178 patients with uncomplicated nondiabetic HT...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.145
更新日期:2010-10-01 00:00:00