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Short-term effects of angiotensin receptor blockers on blood pressure control, and plasma inflammatory and fibrinolytic parameters in patients taking angiotensin-converting enzyme inhibitors

Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey, agirbasli{at}gmail.com

Altug Cincin

Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey

Oytun A Baykan

Department of Cardiology, Marmara University School of Medicine, Istanbul, Turkey

Introduction. Angiotensin-converting enzyme (ACE) inhibitors reduce cardiovascular events in patients with established vascular disease and heart failure (HF). ACE-inhibitors have important effects on fibrinolytic balance, which may be the underlying mechanism for a reduction in cardiovascular events.Although angiotensin-receptor blockers (ARBs) offer greater tolerability than ACE-inhibitors, the major ARB trials have demonstrated a lack of reduction in myocardial infarction (MI) occurrence and mortality in contrast to ACE-inhibitors. In this study, we investigated the combined effects of ARBs and ACE-inhibitors on fibrinolytic and inflammatory parameters in patients with uncontrolled hypertension.

Methods. Twenty-four patients with uncontrolled hypertension despite taking adequate doses of ACE-inhibitor therapy were selected. Patients were started on Candesartan 16 mg once a day. Plasma plasminogen activator inhibitor (PAI-1) antigen (Ag), tissue plasminogen activator (t-PA) Ag, thrombin-activatable fibrinolysis inhibitor (TAFI) % activity and high sensitivity C-reactive protein (hsCRP) levels, were measured during low salt intake at baseline and two weeks after therapy with an ARB.

Results. Addition of ARB to the regimen reduced systolic (155±17 R vs. 139±13, p<0.001), and diastolic (91±9 vs. 81±8, p<0.001) blood pressures (BP). No significant changes were observed in PAI-1 Ag (66±51 vs. 68±52, p=0.9), t-PAAg (12.6±5.3 vs. 13.3±4.7, p=0.3),TAFI % activity (119±30 vs. 118±32, p=0.9) and hsCRP (3.9±3.4 vs. 3.6±3.6, p=0.7) levels after adding an ARB.

Conclusions. Combined ARB and ACE-inhibitor use provide better BP control without any detrimental effect in plasma inflammatory and fibrinolytic parameters.

Key Words: angiotensin-converting enzyme inhibitor • angiotensin receptor blocker • high sensitive C-reactive protein • hypertension • plasma plasminogen activator inhibitor • tissue plasminogen activator

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Journal of Renin-Angiotensin-Aldosterone System, Vol. 9, No. 1, 22-26 (2008)
DOI: 10.3317/jraas.2008.004


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This Article Abstract Free Full Text (Free PDF) Free 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 Agirbasli, M. Articles by Baykan, O. A Search for Related Content PubMed PubMed Citation Articles by Agirbasli, M. Articles by Baykan, O. A Social Bookmarking                         What's this?