Key result
Valsartan reduced plasma PAI-1 levels by a mean difference of -9.5 ng/ml compared to non-RAS inhibitor treatment in hypertensive patients with metabolic syndrome.
Why the study?
Does valsartan improve adiponectin and PAI-1 levels in hypertensive patients with metabolic syndrome compared to non-RAS inhibitor treatment?
RCT (n=150)
open-label
randomly assigned
Yes
Does valsartan improve adiponectin and PAI-1 levels in hypertensive patients with metabolic syndrome compared to non-RAS inhibitor treatment?
Valsartan significantly reduced plasma PAI-1 levels compared to non-RAS inhibitors in hypertensive patients with metabolic syndrome, suggesting a potential benefit in improving fibrinolytic function.
Answers are grounded in this paper and cite their sources.
Supports valsartan for potential fibrinolytic benefit in metabolic syndrome hypertension; extends RAS inhibitor effects to PAI-1 modulation.
BACKGROUND: The purpose of this study was to analyze the effect of valsartan on abnormal adipocyte metabolism and prothrombotic state in hypertensive patients with metabolic syndrome (MetS). METHODS AND RESULTS: We conducted a multicenter, prospective, randomized, parallel-group controlled trial in 150 hypertensive patients with MetS. They were randomly assigned to receive either 80-160 mg valsartan per day (valsartan group, n=79) or other conventional treatment without a renin-angiotensin system (RAS) inhibitor (non-RAS inhibitor group, n=71). After 1 year, there were no significant differences between the 2 groups in the changes in systolic and diastolic blood pressures (valsartan: 153±15/86±15 to 138±16/77±12 mmHg; non-RAS inhibitor: 150±14/82±15 to 137±15/76±10 mmHg). There was a significant difference in the change in the levels of plasminogen activator inhibitor-1 (PAI-1) between the 2 groups after 1 year (valsartan: 3.7±3.2 ng/ml; non-RAS inhibitor: 5.8±3.3 ng/ml, P=0.04). There was no significant difference between groups in the change in the concentration of adiponectin after 1 year (valsartan: 0.3±0.4 µg/ml; non-RAS inhibitor: 0.9±0.4 µg/ml, P=0.22). The animal study showed aortic PAI-1 protein expression was reduced in double knockout mice of angiotensin II type 1a receptor and apolipoprotein E (apoE) compared with the apoE knockout mice. CONCLUSIONS: Valsartan reduced plasma PAI-1 levels compared to non-RAS inhibitor in hypertensive patients with MetS, which suggests it may be useful for improving fibrinolytic function.
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Miyata et al. (2012) conducted an RCT in Hypertension with metabolic syndrome (n=150). Valsartan vs. Non-RAS inhibitor antihypertensive treatment was evaluated on Change in PAI-1 antigen levels (MD -9.5 ng/ml, 95% CI -0.4 to -18.6, p=0.04). Valsartan reduced plasma PAI-1 levels by a mean difference of -9.5 ng/ml compared to non-RAS inhibitor treatment in hypertensive patients with metabolic syndrome.
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