This Article Free Full Text (Free PDF) Free References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Davies, J. Articles by Struthers, A. Search for Related Content PubMed PubMed Citation Articles by Davies, J. Articles by Struthers, A. Social Bookmarking                         What's this?

Do Losartan and Atenolol have Differential Effects on BNP and Central Haemodynamic Parameters?

Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee UK, j.i.davies{at}dundee.ac.uk

Elaine Carr

Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee UK

Margaret Band

Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee UK

Andrew Morris

Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee UK

Allan Struthers

Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee UK

Introduction. It has been suggested that angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) have a differential effect on brachial and aortic haemodynamics. This is why they seem to have beneficial effects that are beyond brachial blood pressure (BP) lowering. We aimed to investigate if this was the case with losartan when compared to atenolol. We also investigated the differential effect of losartan and atenolol on the prognostic marker, brain type natriuretic peptide (BNP).

Methods. We studied 17 patients who were similar to those in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Patients were randomised to receive four months of losartan and atenolol in a crossover fashion. Main outcome measures were BNP and Augmentation index (AIx), which gives an indication of central haemodynamics. Brachial pulse wave velocity (PWV) and time to reflected wave (Tr) were measured as an indication of vascular stiffness.

Results. BNP was significantly lower on losartan than atenolol (p=0.007). AIx was lower on losartan than atenolol (p=0.03), however, this result was not significant when heart rate was considered as a covariate (p=0.09). Heart rate was significantly lower on atenolol than losartan (p=0.03). There was no difference between treatments for both brachial PWV and Tr (p=0.2 and p=0.99, respectively).

Conclusion. The benefits seen when losartan was compared to atenolol in the LIFE trial may be due to a reduction in BNP. We failed to detect a differential effect in central compared to peripheral haemodynamics when losartan was compared to atenolol.

Key Words: Blood pressure • Augmentation • Losartan • Atenolol

Journal of Renin-Angiotensin-Aldosterone System, Vol. 6, No. 3, 151-153 (2005)
DOI: 10.3317/jraas.2005.022


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?