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Effects of olmesartan medoxomil, an angiotensin II type 1 receptor antagonist, on plasma concentration of B-type natriuretic peptide, in hypertensive patients with type 2 diabetes mellitus: a preliminary, observational, open-label study.
Clin Drug Investig. 2011; 31(4):237-45.CD

Abstract

BACKGROUND AND OBJECTIVE

Angiotensin II type 1 (AT1) receptor antagonists (angiotensin receptor blockers [ARBs]) are widely used for the treatment of not only hypertension but also cardiac dysfunction. B-type natriuretic peptide (BNP) is secreted mainly by the cardiac ventricle and plays an important role in the regulation of blood pressure (BP) and body fluid. It has been established that the plasma level of BNP is increased in patients with chronic heart failure in proportion to the severity of cardiac dysfunction. Because cardiac dysfunction is closely associated with a high risk of mortality in patients with diabetes mellitus, early identification and prevention of cardiac dysfunction are important. The objective of this study was to determine the effects of olmesartan medoxomil, a novel ARB, on the plasma level of BNP in hypertensive patients with type 2 diabetes.

METHODS

This was a preliminary, prospective, observational, open-label study. Sixty-eight type 2 diabetic patients with hypertension (systolic BP [SBP]≥140 mmHg or diastolic BP [DBP]≥90 mmHg) received olmesartan medoxomil 10–20 mg/day for 24 weeks. Plasma levels of BNP, as well as several clinical parameters of glycaemic control and lipid metabolism, were compared before and after 24 weeks of treatment. Another group consisting of 22 age- and body mass index-matched subjects not treated with olmesartan medoxomil was observed for reference purposes.

RESULTS

In the olmesartan medoxomil group, mean±SD SBP decreased from 152.8±16.4 at baseline to 146.8±14.4 mmHg after 24 weeks' treatment (p<0.05); similarly, mean±SD DBP decreased from 85.6±10.5 to 81.3±11.6 mmHg (p<0.05). In 53 subjects in whom plasma levels of BNP could be measured both before and after treatment, mean±SD BNP decreased from 41.3±49.9 to 32.5±36.3 pg/mL (p<0.05). Change in plasma BNP level over the 24-week treatment period in the olmesartan medoxomil group was not correlated with change in SBP or DBP. Multiple regression analysis revealed that change in plasma BNP level was not correlated with baseline value of or change in any other parameters. No other parameters in the olmesartan medoxomil group, and no parameters in the non-olmesartan medoxomil reference group, showed significant changes.

CONCLUSION

The current preliminary study showed that olmesartan medoxomil treatment might decrease plasma BNP levels, independent of its BP-lowering effect, in hypertensive patients with type 2 diabetes.

Authors+Show Affiliations

Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan. tkawai@sc.itc.keio.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 availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

21184621

Citation

Kawai, Toshihide, et al. "Effects of Olmesartan Medoxomil, an Angiotensin II Type 1 Receptor Antagonist, On Plasma Concentration of B-type Natriuretic Peptide, in Hypertensive Patients With Type 2 Diabetes Mellitus: a Preliminary, Observational, Open-label Study." Clinical Drug Investigation, vol. 31, no. 4, 2011, pp. 237-45.
Kawai T, Takei I, Shimada A, et al. Effects of olmesartan medoxomil, an angiotensin II type 1 receptor antagonist, on plasma concentration of B-type natriuretic peptide, in hypertensive patients with type 2 diabetes mellitus: a preliminary, observational, open-label study. Clin Drug Investig. 2011;31(4):237-45.
Kawai, T., Takei, I., Shimada, A., Hirata, T., Tanaka, K., Saisho, Y., Irie, J., Horimai, C., Matsumoto, H., & Itoh, H. (2011). Effects of olmesartan medoxomil, an angiotensin II type 1 receptor antagonist, on plasma concentration of B-type natriuretic peptide, in hypertensive patients with type 2 diabetes mellitus: a preliminary, observational, open-label study. Clinical Drug Investigation, 31(4), 237-45. https://doi.org/10.2165/11586510-000000000-00000
Kawai T, et al. Effects of Olmesartan Medoxomil, an Angiotensin II Type 1 Receptor Antagonist, On Plasma Concentration of B-type Natriuretic Peptide, in Hypertensive Patients With Type 2 Diabetes Mellitus: a Preliminary, Observational, Open-label Study. Clin Drug Investig. 2011;31(4):237-45. PubMed PMID: 21184621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of olmesartan medoxomil, an angiotensin II type 1 receptor antagonist, on plasma concentration of B-type natriuretic peptide, in hypertensive patients with type 2 diabetes mellitus: a preliminary, observational, open-label study. AU - Kawai,Toshihide, AU - Takei,Izumi, AU - Shimada,Akira, AU - Hirata,Takumi, AU - Tanaka,Kumiko, AU - Saisho,Yoshifumi, AU - Irie,Junichiro, AU - Horimai,Chihiro, AU - Matsumoto,Hideo, AU - Itoh,Hiroshi, PY - 2010/12/28/entrez PY - 2010/12/28/pubmed PY - 2011/5/11/medline SP - 237 EP - 45 JF - Clinical drug investigation JO - Clin Drug Investig VL - 31 IS - 4 N2 - BACKGROUND AND OBJECTIVE: Angiotensin II type 1 (AT1) receptor antagonists (angiotensin receptor blockers [ARBs]) are widely used for the treatment of not only hypertension but also cardiac dysfunction. B-type natriuretic peptide (BNP) is secreted mainly by the cardiac ventricle and plays an important role in the regulation of blood pressure (BP) and body fluid. It has been established that the plasma level of BNP is increased in patients with chronic heart failure in proportion to the severity of cardiac dysfunction. Because cardiac dysfunction is closely associated with a high risk of mortality in patients with diabetes mellitus, early identification and prevention of cardiac dysfunction are important. The objective of this study was to determine the effects of olmesartan medoxomil, a novel ARB, on the plasma level of BNP in hypertensive patients with type 2 diabetes. METHODS: This was a preliminary, prospective, observational, open-label study. Sixty-eight type 2 diabetic patients with hypertension (systolic BP [SBP]≥140 mmHg or diastolic BP [DBP]≥90 mmHg) received olmesartan medoxomil 10–20 mg/day for 24 weeks. Plasma levels of BNP, as well as several clinical parameters of glycaemic control and lipid metabolism, were compared before and after 24 weeks of treatment. Another group consisting of 22 age- and body mass index-matched subjects not treated with olmesartan medoxomil was observed for reference purposes. RESULTS: In the olmesartan medoxomil group, mean±SD SBP decreased from 152.8±16.4 at baseline to 146.8±14.4 mmHg after 24 weeks' treatment (p<0.05); similarly, mean±SD DBP decreased from 85.6±10.5 to 81.3±11.6 mmHg (p<0.05). In 53 subjects in whom plasma levels of BNP could be measured both before and after treatment, mean±SD BNP decreased from 41.3±49.9 to 32.5±36.3 pg/mL (p<0.05). Change in plasma BNP level over the 24-week treatment period in the olmesartan medoxomil group was not correlated with change in SBP or DBP. Multiple regression analysis revealed that change in plasma BNP level was not correlated with baseline value of or change in any other parameters. No other parameters in the olmesartan medoxomil group, and no parameters in the non-olmesartan medoxomil reference group, showed significant changes. CONCLUSION: The current preliminary study showed that olmesartan medoxomil treatment might decrease plasma BNP levels, independent of its BP-lowering effect, in hypertensive patients with type 2 diabetes. SN - 1173-2563 UR - https://www.unboundmedicine.com/medline/citation/21184621/Effects_of_olmesartan_medoxomil_an_angiotensin_II_type_1_receptor_antagonist_on_plasma_concentration_of_B_type_natriuretic_peptide_in_hypertensive_patients_with_type_2_diabetes_mellitus:_a_preliminary_observational_open_label_study_ L2 - https://dx.doi.org/10.2165/11586510-000000000-00000 DB - PRIME DP - Unbound Medicine ER -