What question did this study set out to answer?

To assess whether selective angiotensin II type 1 receptor blockade with losartan affects fibrinolytic parameters and catecholamine levels under basal conditions and during acute hyperinsulinemia in patients with moderate hypertension.

June 1, 1996Hypertension

Effect of Angiotensin II Receptor Blockade on Fibrinolysis During Acute Hyperinsulinemia in Patients With Essential Hypertension

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Why the study?

Does losartan alter fibrinolysis and catecholamine levels during acute hyperinsulinemia in patients with moderate hypertension?

Population

20 subjects with moderate hypertension

Comparison

Losartan for 4-week treatment periods vs Placebo for 4-week treatment periods

Design

RCT, randomized crossover, double-blind, placebo-controlled

Follow-up

4-week treatment periods

Authors

ISIngebjørg SeljeflotPreventive Cardiology AMAndreas MoanOslo University Hospital SKSverre E. KjeldsenPreventive Cardiology

Discussion

Member takes

Implication

Losartan leaves fibrinolytic and catecholamine responses to hyperinsulinemia unchanged; confirms neutral short-term effect of AT1 blockade on these markers in moderate hypertension.

Key Points

To assess whether selective angiotensin II type 1 receptor blockade with losartan affects fibrinolytic parameters and catecholamine levels under basal conditions and during acute hyperinsulinemia in patients with moderate hypertension.
Randomized, double-blind, placebo-controlled crossover study involving 20 patients with moderate hypertension receiving 4-week treatment periods.
Evaluated plasma catecholamines, tissue plasminogen activator (tPA) activity and antigen, and plasminogen activator inhibitor type 1 (PAI-1) activity and antigen under basal conditions and during acute hyperinsulinemia induced by oral glucose tolerance test and euglycemic glucose clamp.
Basal plasma levels of catecholamines, tPA activity and antigen, and PAI-1 activity and antigen remained unchanged following 4 weeks of losartan treatment compared with placebo.
Acute hyperinsulinemia in both models significantly reduced PAI-1 activity and antigen (both P < 0.001) and significantly increased tPA activity (P < 0.01), but changes from baseline did not differ between losartan and placebo regimens.
Norepinephrine levels remained unchanged across all procedures, while epinephrine increased significantly at 3 hours post-oral glucose challenge, with no treatment differences observed.

Structured PICO

Does losartan alter fibrinolysis and catecholamine levels during acute hyperinsulinemia in patients with moderate hypertension?

Population

20 subjects with moderate hypertension

Intervention

Losartan for 4-week treatment periods

Comparator

Placebo for 4-week treatment periods (crossover design)

Outcome

Plasma levels of catecholamines (norepinephrine, epinephrine), tissue plasminogen activator activity and antigen, and plasminogen activator inhibitor type 1 activity and antigen in basal conditions and during acute hyperinsulinemiasurrogate

Four weeks of AT1 receptor blockade with losartan does not significantly affect fibrinolytic variables or catecholamine levels during acute hyperinsulinemia in patients with moderate hypertension.

Cite This Study

Seljeflot et al. (1996) studied this question.

synapsesocial.com/papers/6a76a2c8a0847c3df1ec2023 https://doi.org/10.1161/01.hyp.27.6.1299

Topics

Hypertension management

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Implication

Losartan leaves fibrinolytic and catecholamine responses to hyperinsulinemia unchanged; confirms neutral short-term effect of AT1 blockade on these markers in moderate hypertension.

Effect of Angiotensin II Receptor Blockade on Fibrinolysis During Acute Hyperinsulinemia in Patients With Essential Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Effect of Angiotensin II Receptor Blockade on Fibrinolysis During Acute Hyperinsulinemia in Patients With Essential Hypertension

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider