Key result
Olmesartan lowered systolic and diastolic blood pressure compared with placebo, with greater reductions in subjects with higher basal plasma renin activity.
Why the study?
Does olmesartan alter blood pressure and arterial compliance in relation to the renin-aldosterone system in unmedicated normotensive subjects?
Does olmesartan alter blood pressure and arterial compliance in relation to the renin-aldosterone system in unmedicated normotensive subjects?
Answers are grounded in this paper and cite their sources.
In normotensive subjects, plasma renin activity is a physiologic determinant of arterial compliance and predicts the blood pressure and compliance response to the angiotensin receptor blocker olmesartan.
The extent to which the clinical effects of angiotensin receptor blockers (ARB) are related to ambient renin system activity remains poorly defined. Therefore, we measured blood pressure (BP), large (C1) and small (C2) arterial compliance, systemic vascular resistance (SVR), plasma renin activity (PRA), and the 24-h urinary excretion of sodium (UNaV) and aldosterone before and 1, 2, 4, and 24 h after administration of single doses of placebo, and 5, 20, and 40 mg of the ARB olmesartan medoxomil to 12 unmedicated normotensive subjects. In the basal state, SVR was inversely related to UNaV ( r =-0,3, p =0,04); the greater the UNaV, the more vasodilated the subject. Indices of arterial compliance, both C1 ( r =-0,32, p =0,03) and C2 ( r =-0,35, p =0,02) were inversely related to the basal PRA. Renin also predicted olmesartan-induced changes in C1 ( r =0,43, p =0,004) and C2 r =0,33, p =0,04). The greater the basal PRA, the less the arterial compliance, and the more compliance improved after olmesartan. Both systolic ( p =0,003) and diastolic ( p <0,0001) BP fell significantly on olmesartan compared with placebo (MANOVA with time), and relations were observed between the basal PRA and olmesartan-induced changes in pressure (systolic BP: r =-0,414, p =0,012; diastolic BP: r =-0.561, p <0,0001) — the greater the initial PRA, the more olmesartan lowered BP. Furthermore, the more pressure fell, the more PRA rose reciprocally ( r =-0,44, p =0,007). Finally, aldosterone excretion fell (sig=0,05) on each dose of olmesartan compared with placebo. We conclude that 1) the inverse relation of UNaV and SVR illustrates the reciprocal role of volume versus constrictor factors in maintaining normal BP; and 2) PRA is a physiologic determinant of arterial compliance in normal individuals and of the response to the ARB olmesartan. Measurement of PRA may help to predict clinical ARB responses in individual subjects.
No takes yet. Share an insight, caveat, or question.
Resnick et al. (2011) studied Normotension (n=12). Olmesartan medoxomil vs. Placebo was evaluated on Blood pressure, arterial compliance, systemic vascular resistance, plasma renin activity, and urinary excretion of sodium and aldosterone (p=<0.0001). Olmesartan lowered systolic and diastolic blood pressure compared with placebo, with greater reductions in subjects with higher basal plasma renin activity.
Synapse has enriched 10 related papers. Consider them for comparative context: