Different actions of losartan and ramipril on adipose tissue activity and vascular remodeling biomarkers in hypertensive patients.

Abstract

We planned a randomized, double blind clinical trial to evaluate whether an antihypertensive intervention at the proximal or distal level of the renin-angiotensin-aldosterone system could have different effects on a broad range of innovative cardiovascular risk biomarkers. A total of 288 hypertensive Caucasian patients (115 men and 113 women), aged ≥ 18 years, were enrolled in this study. They were randomized to take losartan 50 mg per day or ramipril 5 mg per day for 1 month and titrated up to 100 mg per day and 10 mg per day for 13 months, respectively. At baseline, 1, 2 and 14 months after therapy initiation, we evaluated the following parameters: body weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), M-value, adiponectin (ADN), resistin (r), retinol binding protein-4 (RBP-4), visfatin, vaspin, high-sensitivity C-reactive protein (Hs-CRP), matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9). No variation of body weight, BMI, FPG or vaspin was obtained with either treatment. We recorded a similar improvement in SBP, DBP and Hs-CRP with both treatments; however, losartan also increased M-value, ADN and visfatin, whereas ramipril did not. Furthermore, losartan decreased r, RBP-4, MMP-2 and MMP-9, whereas ramipril did not have any effect on these parameters. In conclusion, we observed that short-term treatment with losartan improved several metabolic parameters (M-value, ADN, RBP-4, r and visfatin) and decreased vascular remodeling biomarkers (MMP-2 and MMP-9) in hypertensive subjects, whereas ramipril did not.

• Authors: Giuseppe Derosa, Pamela Maffioli, Ilaria Ferrari, Ilaria Palumbo, Sabrina Randazzo, Elena Fogari, Angela D'Angelo, Arrigo F G Cicero
• Journal: Hypertension research : official journal of the Japanese Society of Hypertension (Hypertens Res) Vol. 34 Issue 1 Pg. 145-51 (Jan 2011) ISSN: 1348-4214 [Electronic] England
• PMID: 21107327 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Antihypertensive Agents
• Biomarkers
• Blood Glucose
• Losartan
• Ramipril

Topics

• Adipose Tissue (drug effects)
• Adult
• Antihypertensive Agents (pharmacology, therapeutic use)
• Biomarkers (blood)
• Blood Glucose (drug effects)
• Blood Pressure (drug effects)
• Body Mass Index
• Body Weight (drug effects)
• Double-Blind Method
• Enzyme-Linked Immunosorbent Assay
• Female
• Glucose Clamp Technique
• Humans
• Hypertension (blood, drug therapy)
• Intention to Treat Analysis
• Linear Models
• Losartan (pharmacology, therapeutic use)
• Male
• Middle Aged
• Ramipril (pharmacology, therapeutic use)
• Treatment Outcome