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A 52-week prospective, cohort study of the effects of losartan with or without hydrochlorothiazide (HCTZ) in hypertensive patients with metabolic syndrome.

https://arctichealth.org/en/permalink/ahliterature145472
Source
J Hum Hypertens. 2010 Nov;24(11):739-48
Publication Type
Article
Date
Nov-2010
Author
N. Racine
P. Hamet
J S Sampalis
N. Longo
N. Bastien
Author Affiliation
Department of Medicine, Montreal Heart Institute, Montréal, Québec, Canada.
Source
J Hum Hypertens. 2010 Nov;24(11):739-48
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Angiotensin II Type 1 Receptor Blockers - adverse effects - therapeutic use
Antihypertensive Agents - adverse effects - therapeutic use
Biological Markers - blood
Blood Glucose - drug effects - metabolism
Blood Pressure - drug effects
Calcium Channel Blockers - therapeutic use
Canada
Chi-Square Distribution
Diabetes Mellitus - blood - chemically induced
Diuretics - adverse effects - therapeutic use
Drug Therapy, Combination
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hydrochlorothiazide - adverse effects - therapeutic use
Hypertension - blood - complications - drug therapy - physiopathology
Linear Models
Losartan - adverse effects - therapeutic use
Male
Metabolic Syndrome X - blood - complications - physiopathology
Middle Aged
Prospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
The impact of an ARB, with or without hydrochlorothiazide (HCTZ), on glycaemic factors and the risk for developing diabetes in hypertensive patients with the metabolic syndrome have not been fully assessed. This was a 52-week multicentre, prospective, phase-IV, open-label, cohort study of losartan or losartan/HCTZ in hypertensive patients with metabolic syndrome. All subjects were treated initially with losartan 50?mg?day(-1). Those not achieving target blood pressure (BP
PubMed ID
20147971 View in PubMed
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Is blockade of the Renin-Angiotensin system able to reverse the structural and functional remodeling of the left ventricle in severe aortic stenosis?

https://arctichealth.org/en/permalink/ahliterature270868
Source
J Cardiovasc Pharmacol. 2015 Mar;65(3):233-40
Publication Type
Article
Date
Mar-2015
Author
Satu Helske-Suihko
Mika Laine
Jyri Lommi
Maija Kaartinen
Kalervo Werkkala
Petri T Kovanen
Markku Kupari
Source
J Cardiovasc Pharmacol. 2015 Mar;65(3):233-40
Date
Mar-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - adverse effects - therapeutic use
Aortic Valve Stenosis - complications - diagnosis - drug therapy - physiopathology
Benzimidazoles - adverse effects - therapeutic use
Biomarkers - blood
Disease Progression
Exercise Tolerance - drug effects
Female
Finland
Humans
Hypertrophy, Left Ventricular - diagnosis - drug therapy - etiology - physiopathology
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Peptide Fragments - blood
Recovery of Function
Renin-Angiotensin System - drug effects
Severity of Illness Index
Tetrazoles - adverse effects - therapeutic use
Time Factors
Treatment Outcome
Ventricular Dysfunction, Left - diagnosis - drug therapy - etiology - physiopathology
Ventricular Function, Left - drug effects
Ventricular Remodeling - drug effects
Abstract
: In experimental aortic stenosis (AS), blockade of the renin-angiotensin system attenuates AS-related left ventricular (LV) dysfunction and improves survival. We tested whether candesartan, an angiotensin II type 1 receptor blocker, favorably influences LV structure and function and improves exercise capacity in AS patients. Fifty-one patients with severe AS were randomized to receive candesartan (target dose 16 mg/d) or placebo. Eight patients discontinued treatment and the remaining 43 patients underwent echocardiography, walking test, and measurement of plasma N-terminal B-type natriuretic peptide (Nt-proBNP) before and after an average of 5-month treatment. No statistically significant changes in LV diameters, mass, or function were seen. The median 6-minute walking distance decreased from 390 to 368 m with candesartan (P = 0.003) and from 380 to 370 m with placebo (P = 0.523), reflecting natural progression of AS. Concomitantly, median Nt-proBNP increased from 319 to 414 ng/L with candesartan (P = 0.170) and from 413 to 561 ng/L with placebo (P = 0.035). No change with candesartan was statistically significantly different from the corresponding change with placebo. In conclusion, candesartan was well tolerated but had no favorable effects on the LV or effort tolerance. The benefits found in experimental AS of blocking the renin-angiotensin system could not be reproduced in patients with severe AS.
PubMed ID
25469804 View in PubMed
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Ongoing treatment with renin-angiotensin-aldosterone-blocking agents does not predict normoalbuminuric renal impairment in a general type 2 diabetes population.

https://arctichealth.org/en/permalink/ahliterature117998
Source
J Diabetes Complications. 2013 May-Jun;27(3):229-34
Publication Type
Article
Author
Hanri Afghahi
Mervete Miftaraj
Ann-Marie Svensson
Henrik Hadimeri
Soffia Gudbjörnsdottir
Björn Eliasson
Maria K Svensson
Author Affiliation
Department of Nephrology, Kärnsjukhuset, Skövde, Sweden.
Source
J Diabetes Complications. 2013 May-Jun;27(3):229-34
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - adverse effects - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - adverse effects - therapeutic use
Antihypertensive Agents - adverse effects - therapeutic use
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - complications
Diabetic Nephropathies - epidemiology - etiology - physiopathology
Diabetic Retinopathy - epidemiology - etiology - physiopathology
Drug Prescriptions
Female
Humans
Hypertension - complications - drug therapy - physiopathology
Kidney - drug effects - physiopathology
Male
Middle Aged
Prevalence
Registries
Renin-Angiotensin System - drug effects
Severity of Illness Index
Sweden - epidemiology
Abstract
To examine the prevalence and the clinical characteristics associated with normoalbuminuric renal impairment (RI) in a general type 2 diabetes (T2D) population.
We included 94 446 patients with T2D (56% men, age 68.3±11.6 years, BMI 29.6±5.3 kg/m², diabetes duration 8.5±7.1 years; means±SD) with renal function (serum creatinine) reported to the Swedish National Diabetes Register (NDR) in 2009. RI was defined as estimated glomerular filtration (eGFR)20 µg/min. We linked the NDR to the Swedish Prescribed Drug Register, and the Swedish Cause of Death and the Hospital Discharge Register to evaluate ongoing medication and clinical outcomes.
17% of the patients had RI, and 62% of these patients were normoalbuminuric. This group of patients had better metabolic control, lower BMI, lower systolic blood pressure and were more often women, non-smokers and more seldom had a history of cardiovascular disease as compared with patients with albuminuric RI. 28% of the patients with normoalbuminuric RI had no ongoing treatment with any RAAS-blocking agent. Retinopathy was most common in patients with RI and albuminuria (31%).
The majority of patients with type 2 diabetes and RI were normoalbuminuric despite the fact that 25% of these patients had no ongoing treatment with RAAS-blocking agents. Thus, RI in many patients with type 2 diabetes is likely to be caused by other factors than diabetic microvascular disease and ongoing RAAS-blockade.
PubMed ID
23246248 View in PubMed
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Predictors of antihypertensive drug responses: initial data from a placebo-controlled, randomized, cross-over study with four antihypertensive drugs (The GENRES Study).

https://arctichealth.org/en/permalink/ahliterature164961
Source
Am J Hypertens. 2007 Mar;20(3):311-8
Publication Type
Article
Date
Mar-2007
Author
Timo P Hiltunen
Timo Suonsyrjä
Tuula Hannila-Handelberg
Kristian J Paavonen
Helena E Miettinen
Timo Strandberg
Ilkka Tikkanen
Reijo Tilvis
Pertti J Pentikäinen
Juha Virolainen
Kimmo Kontula
Author Affiliation
Department of Medicine, University of Helsinki, and Biomedicum Helsinki, Helsinki, Finland.
Source
Am J Hypertens. 2007 Mar;20(3):311-8
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - adverse effects - therapeutic use
Adult
Amlodipine - therapeutic use
Angiotensin II Type 1 Receptor Blockers - adverse effects - therapeutic use
Antihypertensive Agents - adverse effects - therapeutic use
Bisoprolol - therapeutic use
Blood Pressure - drug effects
Blood Pressure Monitoring, Ambulatory
Calcium Channel Blockers - adverse effects - therapeutic use
Cross-Over Studies
Diuretics - adverse effects - therapeutic use
Double-Blind Method
Drug Therapy, Combination
Finland
Genetic Variation
Genotype
Humans
Hydrochlorothiazide - therapeutic use
Hypertension - drug therapy - genetics - physiopathology
Losartan - therapeutic use
Male
Middle Aged
Phenotype
Predictive value of tests
Prospective Studies
Reproducibility of Results
Time Factors
Treatment Outcome
Abstract
Only a minority of hypertensive individuals is adequately controlled for their hypertension, partially because reliable predictors for efficient antihypertensive drug therapy are lacking.
In a prospective, randomized, double-blind, cross-over, placebo-controlled study (The GENRES Study), 208 moderately hypertensive Finnish men (aged 35 to 60 years) were treated for 4 weeks with antihypertensive drugs from four different classes: amlodipine (5 mg), bisoprolol (5 mg), hydrochlorothiazide (25 mg), or losartan (50 mg) daily. Each individual received each of the four monotherapies in a randomized order. Four-week placebo periods were included before and between drug treatment periods. Antihypertensive responses were assessed with 24-h ambulatory and office measurements and analyzed according to age, body mass index, triceps skin fold thickness, waist-to-hip ratio, duration of hypertension, number of previous antihypertensive drugs, number of affected parents, and blood pressure (BP) levels, and profiles during placebo periods.
The median BP responses in 24-h ambulatory recordings (systolic/diastolic) were 11/8 mm Hg for bisoprolol, 9/6 mm Hg for losartan, 7/5 mm Hg for amlodipine, and 5/2 mm Hg for hydrochlorothiazide. The highest pairwise within-subject correlations in BP responses were seen for the combinations of bisoprolol-losartan and amlodipine-hydrochlorothiazide. The BP responses to bisoprolol and losartan did not vary according to the variables. Amlodipine and hydrochlorothiazide responses were positively correlated with age, placebo BP level, and lower night-time dipping on placebo.
Baseline clinical and BP parameters may be used to predict the efficacy of antihypertensive therapies. The GENRES Study material should provide an excellent platform for future pharmacogenetic analyses of antihypertensive drug responsiveness.
PubMed ID
17324745 View in PubMed
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Sex differences in the effectiveness of angiotensin receptor blockers and angiotensin converting enzyme inhibitors in patients with congestive heart failure--a population study.

https://arctichealth.org/en/permalink/ahliterature164462
Source
Eur J Heart Fail. 2007 Jun-Jul;9(6-7):602-9
Publication Type
Article
Author
Marie Hudson
Elham Rahme
Hassan Behlouli
Richard Sheppard
Louise Pilote
Author Affiliation
Division of Clinical Epidemiology, The Research Institute of the McGill University Health Centre, 1650 Cedar Ave, Montreal, QC, Canada. marie.hudson@mcgill.ca
Source
Eur J Heart Fail. 2007 Jun-Jul;9(6-7):602-9
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - adverse effects - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - adverse effects - therapeutic use
Cohort Studies
Female
Heart Failure - drug therapy - mortality
Humans
Male
Quebec
Retrospective Studies
Sex Characteristics
Survival Analysis
Survival Rate
Treatment Outcome
Abstract
Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been shown to improve survival in patients with congestive heart failure (CHF). We wish to determine whether there are sex-related differences in the optimal treatment of congestive heart failure.
Using administrative databases, all patients >=65 years of age discharged with a diagnosis of CHF between January 1998 and March 2003 and who filled a prescription for an ARB or an ACE inhibitor within 90 days of discharge were identified. Time to all-cause death in women and men on ACE inhibitors or ARBs was compared.
There were 10,223 women (8627 ACE inhibitors and 1596 ARBs) and 9475 men (8484 ACE inhibitors and 991 ARBs). Hypertension was more common in women (50.1%) than men (33.1%). Women on ARBs had better survival than those on ACE inhibitors (adjusted hazard ratio (HR) 0.69, 95% confidence interval (CI) 0.59, 0.80). There was no difference in survival in men prescribed ARBs compared to ACE inhibitors (HR 1.10, 95% CI 0.95, 1.30).
These sex differences in treatment-related outcome are important but should be confirmed in a randomized trial before ARBs are preferentially prescribed to women with CHF.
Notes
Comment In: Eur J Heart Fail. 2007 Sep;9(9):963-4; author reply 96417669685
PubMed ID
17383932 View in PubMed
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Treatment with angiotensin converting enzyme inhibitors, angiotensin-II-antagonists and beta-blockers in an unselected group of patients with chronic heart failure.

https://arctichealth.org/en/permalink/ahliterature175781
Source
Eur J Clin Pharmacol. 2005 May;61(3):209-14
Publication Type
Article
Date
May-2005
Author
Ragnar Watz
Ann-Britt Ekstrand
Victoria Engelbrektson
Björn Beermann
Author Affiliation
Department of Medicine, Kristinehamn's Hospital, Kristinehamn, Sweden.
Source
Eur J Clin Pharmacol. 2005 May;61(3):209-14
Date
May-2005
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - adverse effects - therapeutic use
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers - adverse effects - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - adverse effects - therapeutic use
Chronic Disease
Data Collection - methods
Digitalis Glycosides - therapeutic use
Diuretics - therapeutic use
Drug Monitoring - methods
Echocardiography - methods - statistics & numerical data
Female
Heart Failure - diagnosis - drug therapy - epidemiology
Humans
Male
Middle Aged
Prevalence
Radiography - methods - statistics & numerical data
Spironolactone - therapeutic use
Sweden - epidemiology
Treatment Outcome
Ultrasonography - methods - statistics & numerical data
Abstract
Modern diagnostics of chronic heart failure (CHF) is based on echocardiography. Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin-II-antagonists (AIIAs) in case of ACEI intolerance, and beta-blockers are recommended as first-line drugs in patients with CHF and left ventricular systolic dysfunction. The aims of this study were to analyse the diagnostics and treatment of patients with CHF and to identify the optimal drug profile (target level) with regard to ACEI/AIIA- and beta-blocker treatment.
The medical records of all patients (n=635) from a part of a Swedish county who had a diagnosis of CHF in the year 2000 were analysed retrospectively.
The prevalence of CHF increased with age, from 0.9% and 1.6% in the age group 60-64 years in women and men, respectively, to 8.8% and 11.5%, respectively, in the age group 80-84 years. Only 17.6% of the patients had been examined by means of echocardiography. Of the patients without any contra-indication for the drugs, 45.9% received treatment with ACEI/AIIAs and 41.8% with beta-blockers. Treatment with ACEI/AIIAs and beta-blockers was given to 21.3%. The corresponding proportions for treatment of patients with CHF verified by echocardiography were 88.0% (ACEI/AIIA), 52.0% (beta-blocker) and 46.7% (the combination). The target level of the combination treatment was estimated to be about 70% in a group of unselected patients with CHF.
CHF was not optimally diagnosed in this cohort of patients. Correct diagnosing seems to be associated with more adequate treatment.
PubMed ID
15761755 View in PubMed
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6 records – page 1 of 1.