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Angiotensin II type 1 receptor blocker, olmesartan, restores nocturnal blood pressure decline by enhancing daytime natriuresis.
J Hypertens. 2008 Mar; 26(3):583-8.JH

Abstract

OBJECTIVE

We have shown that as renal function deteriorated, night-time fall in both blood pressure and urinary sodium excretion were diminished. We have also reported that sodium intake restriction and diuretics both normalized circadian blood pressure rhythm from nondipper to dipper patterns. In this study, we investigated whether an angiotensin II receptor blocker, olmesartan, could restore night-time blood pressure fall.

METHODS

Twenty patients with chronic kidney disease (13 men, seven women; mean age 44.8 +/- 18.1 years; BMI 22.9 +/- 3.5 kg/m2) were studied. At baseline and 8 weeks after the treatment with olmesartan medoxomil (10-40 mg/day), 24-h blood pressure monitoring and urinary sampling for both daytime (0600-2100 h) and night-time (2100-0600 h) were repeated to compare the circadian rhythms of blood pressure and urinary sodium excretion.

RESULTS

The 24-h mean arterial pressure was lowered by olmesartan, while urinary sodium excretion remained unchanged. On the other hand, daytime urinary sodium excretion was increased from 4.8 +/- 2.2 to 5.7 +/- 2.1 mmol/h, while night-time urinary sodium excretion tended to be reduced from 3.9 +/- 1.7 to 3.4 +/- 1.6 mmol/h. Night/day ratios of mean arterial pressure (0.98 +/- 0.1 to 0.91 +/- 0.08; P = 0.01) and urinary sodium excretion (0.93 +/- 0.5 to 0.68 +/- 0.4; P = 0.0006) were both decreased. Olmesartan enhanced night-time falls more in mean arterial pressure (r = 0.77; r2 = 0.59; P < 0.0001) and urinary sodium excretion (r = 0.59; r2 = 0.34; P = 0.007), especially in patients whose baseline night-time falls were more diminished.

CONCLUSIONS

These findings demonstrated that olmesartan could restore night-time blood pressure fall, as seen with diuretics and sodium restriction, possibly by enhancing daytime sodium excretion. Since nocturnal blood pressure is a strong predictor of cardiovascular events, olmesartan could relieve cardiorenal load through normalization of circadian blood pressure rhythm besides having powerful ability to block the renin-angiotensin system.

Authors+Show Affiliations

Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, Japan. m-fukuda@med.nagoya-cu.ac.jpNo 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)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18300871

Citation

Fukuda, Michio, et al. "Angiotensin II Type 1 Receptor Blocker, Olmesartan, Restores Nocturnal Blood Pressure Decline By Enhancing Daytime Natriuresis." Journal of Hypertension, vol. 26, no. 3, 2008, pp. 583-8.
Fukuda M, Yamanaka T, Mizuno M, et al. Angiotensin II type 1 receptor blocker, olmesartan, restores nocturnal blood pressure decline by enhancing daytime natriuresis. J Hypertens. 2008;26(3):583-8.
Fukuda, M., Yamanaka, T., Mizuno, M., Motokawa, M., Shirasawa, Y., Miyagi, S., Nishio, T., Yoshida, A., & Kimura, G. (2008). Angiotensin II type 1 receptor blocker, olmesartan, restores nocturnal blood pressure decline by enhancing daytime natriuresis. Journal of Hypertension, 26(3), 583-8. https://doi.org/10.1097/HJH.0b013e3282f2fded
Fukuda M, et al. Angiotensin II Type 1 Receptor Blocker, Olmesartan, Restores Nocturnal Blood Pressure Decline By Enhancing Daytime Natriuresis. J Hypertens. 2008;26(3):583-8. PubMed PMID: 18300871.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Angiotensin II type 1 receptor blocker, olmesartan, restores nocturnal blood pressure decline by enhancing daytime natriuresis. AU - Fukuda,Michio, AU - Yamanaka,Tamaki, AU - Mizuno,Masashi, AU - Motokawa,Masahiro, AU - Shirasawa,Yuichi, AU - Miyagi,Sota, AU - Nishio,Takae, AU - Yoshida,Atsuhiro, AU - Kimura,Genjiro, PY - 2008/2/28/pubmed PY - 2008/4/25/medline PY - 2008/2/28/entrez SP - 583 EP - 8 JF - Journal of hypertension JO - J Hypertens VL - 26 IS - 3 N2 - OBJECTIVE: We have shown that as renal function deteriorated, night-time fall in both blood pressure and urinary sodium excretion were diminished. We have also reported that sodium intake restriction and diuretics both normalized circadian blood pressure rhythm from nondipper to dipper patterns. In this study, we investigated whether an angiotensin II receptor blocker, olmesartan, could restore night-time blood pressure fall. METHODS: Twenty patients with chronic kidney disease (13 men, seven women; mean age 44.8 +/- 18.1 years; BMI 22.9 +/- 3.5 kg/m2) were studied. At baseline and 8 weeks after the treatment with olmesartan medoxomil (10-40 mg/day), 24-h blood pressure monitoring and urinary sampling for both daytime (0600-2100 h) and night-time (2100-0600 h) were repeated to compare the circadian rhythms of blood pressure and urinary sodium excretion. RESULTS: The 24-h mean arterial pressure was lowered by olmesartan, while urinary sodium excretion remained unchanged. On the other hand, daytime urinary sodium excretion was increased from 4.8 +/- 2.2 to 5.7 +/- 2.1 mmol/h, while night-time urinary sodium excretion tended to be reduced from 3.9 +/- 1.7 to 3.4 +/- 1.6 mmol/h. Night/day ratios of mean arterial pressure (0.98 +/- 0.1 to 0.91 +/- 0.08; P = 0.01) and urinary sodium excretion (0.93 +/- 0.5 to 0.68 +/- 0.4; P = 0.0006) were both decreased. Olmesartan enhanced night-time falls more in mean arterial pressure (r = 0.77; r2 = 0.59; P < 0.0001) and urinary sodium excretion (r = 0.59; r2 = 0.34; P = 0.007), especially in patients whose baseline night-time falls were more diminished. CONCLUSIONS: These findings demonstrated that olmesartan could restore night-time blood pressure fall, as seen with diuretics and sodium restriction, possibly by enhancing daytime sodium excretion. Since nocturnal blood pressure is a strong predictor of cardiovascular events, olmesartan could relieve cardiorenal load through normalization of circadian blood pressure rhythm besides having powerful ability to block the renin-angiotensin system. SN - 0263-6352 UR - https://www.unboundmedicine.com/medline/citation/18300871/Angiotensin_II_type_1_receptor_blocker_olmesartan_restores_nocturnal_blood_pressure_decline_by_enhancing_daytime_natriuresis_ L2 - https://doi.org/10.1097/HJH.0b013e3282f2fded DB - PRIME DP - Unbound Medicine ER -