Drugs with blocking effects on the renin-angiotensin-aldosterone system do not improve endothelial dysfunction long-term in hypertensive patients
| Autor: | I Hatipoglu, Turkan Tansel, Hasan Kudat, Ahmet Bilge Sözen, Osman Erk, Şeref Demirel, V. Akkaya, Kayacan, A Celebi |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Angiotensin receptor Brachial Artery Urology Angiotensin-Converting Enzyme Inhibitors Blood Pressure Essential hypertension Biochemistry Irbesartan Fosinopril Internal medicine medicine Humans Endothelial dysfunction Diuretics Antihypertensive Agents business.industry Biochemistry (medical) Cell Biology General Medicine Middle Aged medicine.disease Vasodilation Endocrinology Blood pressure Hydrochlorothiazide Treatment Outcome Valsartan Quinapril Chronic Disease Hypertension Drug Therapy Combination Female Endothelium Vascular business medicine.drug |
| Zdroj: | The Journal of international medical research. 37(4) |
| ISSN: | 0300-0605 |
| Popis: | In essential hypertension, endothelial dysfunction has been documented many times and correlates with prognosis. The influence of the renin–angiotensin–aldosterone system (RAAS) on endothelial dysfunction has also been studied. The present study investigated the duration of the effects of RAAS-blocking drugs on endothelial function in 44 consecutive, never-treated, outpatients with mild to moderate hypertension. Patients (11 per group) received an angiotensin receptor blocker (ARB; irbesartan 300 mg/day or valsartan 160 mg/day) or an angiotensin-converting enzyme inhibitor (ACEi; fosinopril 10 mg/day or quinapril 20 mg/day). If target blood pressure (< 140/90 mmHg) was not achieved, 12.5 mg/day hydrochlorothiazide was added. Endothelial function, assessed by measuring brachial artery diameter, did not change significantly after 6 weeks, 1 year or 3 years of treatment in any group. Across all groups, endothelium-dependent and-independent vasodilation increased significantly after 6 weeks but, after 1 year, decreased below baseline and was at a similar level after 3 years; groups did not differ significantly. Both ACEi and ARB had similar effects on endothelial function; improvement occurred at the start of treatmentbut was not maintained. Endothelial dysfunction may be a resistant or irreversible feature of hypertension, requiring high doses of antihypertensive drugs and above-average patient compliance. |
| Databáze: | OpenAIRE |
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