Do losartan and atenolol have differential effects on BNP and central haemodynamic parameters?

Journal of the Renin-angiotensin-aldosterone System : JRAAS
Justine DaviesAllan Struthers

Abstract

It has been suggested that angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin II receptor blockers (ARBs) have a differential effect on brachial and aortic haemodynamics. This is why they seem to have beneficial effects that are beyond brachial blood pressure (BP) lowering. We aimed to investigate if this was the case with losartan when compared to atenolol. We also investigated the differential effect of losartan and atenolol on the prognostic marker, brain type natriuretic peptide (BNP). We studied 17 patients who were similar to those in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Patients were randomised to receive four months of losartan and atenolol in a crossover fashion. Main outcome measures were BNP and Augmentation index (AIx), which gives an indication of central haemodynamics. Brachial pulse wave velocity (PWV) and time to reflected wave (Tr) were measured as an indication of vascular stiffness. BNP was significantly lower on losartan than atenolol (p=0.007). AIx was lower on losartan than atenolol (p=0.03), however, this result was not significant when heart rate was considered as a covariate (p=0.09). Heart rate was significantly lower on atenolol than losartan (p...Continue Reading

References

Oct 6, 2001·The New England Journal of Medicine·J A de LemosE Braunwald
Mar 18, 2003·Journal of Hypertension·Justine Ina Davies, Allan D Struthers
Oct 24, 2003·American Journal of Hypertension·W Stephen WaringSimon R J Maxwell
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Citations

Dec 4, 2010·The American Journal of Cardiology·C Venkata S Ram
May 1, 2012·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Charalambos KoumarasAsterios Karagiannis
Sep 13, 2013·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Eung Ju KimHong Seog Seo
Jun 15, 2007·Annals of Medicine·Richard W TroughtonM Gary Nicholls
Mar 19, 2011·Journal of the American Society of Hypertension : JASH·Haroon KamranJason M Lazar
Dec 7, 2010·Journal of the American Society of Hypertension : JASH·Rhonda KaufmanPeter U Feig
Mar 1, 2008·Journal of the American Society of Hypertension : JASH·Oladipupo OlafiranyeJason M Lazar
Aug 21, 2015·American Journal of Hypertension·Tracey J McGaugheySachin A Shah

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