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Effect of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension.
J Hypertens. 2007 Apr; 25(4):785-91.JH

Abstract

OBJECTIVE

It has been shown that angiotensin-converting enzyme inhibition or angiotensin receptor blockade may improve endothelial dysfunction, an early manifestation of atherosclerosis, in patients with diabetes. Whether this protective effect is mediated through blood pressure-lowering effects or other specific mechanisms such as a reduction in oxidative stress is not clear. We investigated the influence of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension.

METHODS

Thirteen patients were included in this randomized, double-blind, crossover study; they received losartan 50 mg twice daily for 4 weeks followed by atenolol 50 mg twice daily or vice versa. Concomitant medication with renin-angiotensin blocking agents or beta-blockers was withdrawn, whereas other medication remained unchanged. At baseline and after each treatment period, flow-mediated dilation of the brachial artery and oxidative stress were measured in serum samples.

RESULTS

Flow-mediated dilation was increased significantly after 4 weeks' treatment with losartan (3.4 +/- 0.44%) compared with atenolol (2.58 +/- 0.42%; P = 0.01). 8-Isoprostanes, a marker of oxidative stress, were significantly reduced in the losartan group compared with baseline (0.039 +/- 0.007 versus 0.067 +/- 0.006 ng/ml; P = 0.01), but did not differ from baseline with atenolol. Glucose, hemoglobin A1c, highly sensitive C-reactive protein, lipids and systolic blood pressure remained unaltered, whereas diastolic blood pressure tended to be lower in the atenolol group.

CONCLUSIONS

This study demonstrates that losartan significantly improved endothelial function in type 2 diabetes patients with hypertension compared with atenolol. This must be independent of the blood pressure-lowering effect of losartan and is probably caused by an antioxidative effect of the angiotensin receptor blocker.

Authors+Show Affiliations

Cardiovascular Center, Cardiology, University Hospital Zurich, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17351370

Citation

Flammer, Andreas J., et al. "Effect of Losartan, Compared With Atenolol, On Endothelial Function and Oxidative Stress in Patients With Type 2 Diabetes and Hypertension." Journal of Hypertension, vol. 25, no. 4, 2007, pp. 785-91.
Flammer AJ, Hermann F, Wiesli P, et al. Effect of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension. J Hypertens. 2007;25(4):785-91.
Flammer, A. J., Hermann, F., Wiesli, P., Schwegler, B., Chenevard, R., Hürlimann, D., Sudano, I., Gay, S., Neidhart, M., Riesen, W., Ruschitzka, F., Lüscher, T. F., Noll, G., & Lehmann, R. (2007). Effect of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension. Journal of Hypertension, 25(4), 785-91.
Flammer AJ, et al. Effect of Losartan, Compared With Atenolol, On Endothelial Function and Oxidative Stress in Patients With Type 2 Diabetes and Hypertension. J Hypertens. 2007;25(4):785-91. PubMed PMID: 17351370.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension. AU - Flammer,Andreas J, AU - Hermann,Frank, AU - Wiesli,Peter, AU - Schwegler,Beat, AU - Chenevard,Rémy, AU - Hürlimann,David, AU - Sudano,Isabella, AU - Gay,Steffen, AU - Neidhart,Michel, AU - Riesen,Walter, AU - Ruschitzka,Frank, AU - Lüscher,Thomas F, AU - Noll,Georg, AU - Lehmann,Roger, PY - 2007/3/14/pubmed PY - 2007/8/8/medline PY - 2007/3/14/entrez SP - 785 EP - 91 JF - Journal of hypertension JO - J Hypertens VL - 25 IS - 4 N2 - OBJECTIVE: It has been shown that angiotensin-converting enzyme inhibition or angiotensin receptor blockade may improve endothelial dysfunction, an early manifestation of atherosclerosis, in patients with diabetes. Whether this protective effect is mediated through blood pressure-lowering effects or other specific mechanisms such as a reduction in oxidative stress is not clear. We investigated the influence of losartan, compared with atenolol, on endothelial function and oxidative stress in patients with type 2 diabetes and hypertension. METHODS: Thirteen patients were included in this randomized, double-blind, crossover study; they received losartan 50 mg twice daily for 4 weeks followed by atenolol 50 mg twice daily or vice versa. Concomitant medication with renin-angiotensin blocking agents or beta-blockers was withdrawn, whereas other medication remained unchanged. At baseline and after each treatment period, flow-mediated dilation of the brachial artery and oxidative stress were measured in serum samples. RESULTS: Flow-mediated dilation was increased significantly after 4 weeks' treatment with losartan (3.4 +/- 0.44%) compared with atenolol (2.58 +/- 0.42%; P = 0.01). 8-Isoprostanes, a marker of oxidative stress, were significantly reduced in the losartan group compared with baseline (0.039 +/- 0.007 versus 0.067 +/- 0.006 ng/ml; P = 0.01), but did not differ from baseline with atenolol. Glucose, hemoglobin A1c, highly sensitive C-reactive protein, lipids and systolic blood pressure remained unaltered, whereas diastolic blood pressure tended to be lower in the atenolol group. CONCLUSIONS: This study demonstrates that losartan significantly improved endothelial function in type 2 diabetes patients with hypertension compared with atenolol. This must be independent of the blood pressure-lowering effect of losartan and is probably caused by an antioxidative effect of the angiotensin receptor blocker. SN - 0263-6352 UR - https://www.unboundmedicine.com/medline/citation/17351370/Effect_of_losartan_compared_with_atenolol_on_endothelial_function_and_oxidative_stress_in_patients_with_type_2_diabetes_and_hypertension_ L2 - https://doi.org/10.1097/HJH.0b013e3280287a72 DB - PRIME DP - Unbound Medicine ER -