Angiotensin II receptor blockade: is there truly a benefit of adding an ACE inhibitor?

Details

Serval ID
serval:BIB_05B6875D84FC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Angiotensin II receptor blockade: is there truly a benefit of adding an ACE inhibitor?
Journal
Hypertension
Author(s)
Forclaz A., Maillard M., Nussberger J., Brunner H.R., Burnier M.
ISSN
1524-4563[electronic]
Publication state
Published
Issued date
2003
Volume
41
Number
1
Pages
31-6
Language
english
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Abstract
We assessed the blockade of the renin-angiotensin system (RAS) achieved with 2 angiotensin (Ang) antagonists given either alone at different doses or with an ACE inhibitor. First, 20 normotensive subjects were randomly assigned to 100 mg OD losartan (LOS) or 80 mg OD telmisartan (TEL) for 1 week; during another week, the same doses of LOS and TEL were combined with 20 mg OD lisinopril. Then, 10 subjects were randomly assigned to 200 mg OD LOS and 160 mg OD TEL for 1 week and 100 mg BID LOS and 80 mg BID TEL during the second week. Blockade of the RAS was evaluated with the inhibition of the pressor effect of exogenous Ang I, an ex vivo receptor assay, and the changes in plasma Ang II. Trough blood pressure response to Ang I was blocked by 35+/-16% (mean+/-SD) with 100 mg OD LOS and by 36+/-13% with 80 mg OD TEL. When combined with lisinopril, blockade was 76+/-7% with LOS and 79+/-9% with TEL. With 200 mg OD LOS, trough blockade was 54+/-14%, but with 100 mg BID it increased to 77+/-8% (P<0.01). Telmisartan (160 mg OD and 80 mg BID) produced a comparable effect. Thus, at their maximal recommended doses, neither LOS nor TEL blocks the RAS for 24 hours; hence, the addition of an ACE inhibitor provides an additional blockade. A 24-hour blockade can be achieved with an angiotensin antagonist alone, provided higher doses or a BID regimen is used.
Keywords
Adult, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Benzimidazoles, Benzoates, Blood Pressure, Humans, Losartan, Male, Receptors, Angiotensin, Renin-Angiotensin System, Single-Blind Method
Pubmed
Web of science
Open Access
Yes
Create date
05/03/2008 16:40
Last modification date
20/08/2019 12:27
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