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Murray E, Rossitto G, Delles C. Haemodynamic assessment in hypertension: the soloists and the orchestra. J Hypertens 2021; 39:1109-1111. [PMID: 33967215 DOI: 10.1097/hjh.0000000000002796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Eleanor Murray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Giacomo Rossitto
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
- Department of Medicine DIMED, University of Padua, Italy
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
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Vischer AS, Kuster GM, Twerenbold R, Pfister O, Zhou Q, Villiger A, Poglitsch M, Krähenbühl S, Mayr M, Osswald S, Haschke M, Burkard T. Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients. Cells 2021; 10:cells10030534. [PMID: 33802464 PMCID: PMC8001814 DOI: 10.3390/cells10030534] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/15/2021] [Accepted: 02/26/2021] [Indexed: 01/27/2023] Open
Abstract
(1) Background: Recently, influences of antihypertensive treatment on the renin-angiotensin-aldosterone system (RAAS) has gained attention, regarding a possible influence on inflammatory and anti-inflammatory pathways. We aimed to study the effects of newly initiated antihypertensive drugs on angiotensin (Ang) II and Ang (1-7) as representers of two counter-regulatory axes. (2) Methods: In this randomized, open-label trial investigating RAAS peptides after the initiation of perindopril, olmesartan, amlodipine, or hydrochlorothiazide, Ang II and Ang (1-7) equilibrium concentrations were measured at 8 a.m. and 12 a.m. at baseline and after four weeks of treatment. Eighty patients were randomized (1:1:1:1 fashion). (3) Results: Between the four substances, we found significant differences regarding the concentrations of Ang II (p < 0.0005 for 8 a.m., 12 a.m.) and Ang (1-7) (p = 0.019 for 8 a.m., <0.0005 for 12 a.m.) four weeks after treatment start. Ang II was decreased by perindopril (p = 0.002), and increased by olmesartan (p < 0.0005), amlodipine (p = 0.012), and hydrochlorothiazide (p = 0.001). Ang (1-7) was increased by perindopril and olmesartan (p = 0.008/0.002), but not measurably altered by amlodipine and hydrochlorothiazide (p = 0.317/ 0.109). (4) Conclusion: The initiation of all first line antihypertensive treatments causes early and distinct alterations of equilibrium angiotensin levels. Given the additional AT1R blocking action of olmesartan, RAAS peptides shift upon initiation of perindopril and olmesartan appear to work in favor of the anti-inflammatory axis compared to amlodipine and hydrochlorothiazide.
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Affiliation(s)
- Annina S. Vischer
- Hypertension Clinic, Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (M.M.); (T.B.)
- Correspondence:
| | - Gabriela M. Kuster
- Clinic of Cardiology, University Hospital Basel, 4031 Basel, Switzerland; (G.M.K.); (R.T.); (O.P.); (Q.Z.); (S.O.)
- Department of Biomedicine, University Hospital Basel and University of Basel, 4031 Basel, Switzerland
| | - Raphael Twerenbold
- Clinic of Cardiology, University Hospital Basel, 4031 Basel, Switzerland; (G.M.K.); (R.T.); (O.P.); (Q.Z.); (S.O.)
- Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, 4031 Basel, Switzerland
| | - Otmar Pfister
- Clinic of Cardiology, University Hospital Basel, 4031 Basel, Switzerland; (G.M.K.); (R.T.); (O.P.); (Q.Z.); (S.O.)
- Department of Biomedicine, University Hospital Basel and University of Basel, 4031 Basel, Switzerland
| | - Qian Zhou
- Clinic of Cardiology, University Hospital Basel, 4031 Basel, Switzerland; (G.M.K.); (R.T.); (O.P.); (Q.Z.); (S.O.)
| | - Andrea Villiger
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (S.K.); (M.H.)
| | | | - Stephan Krähenbühl
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (S.K.); (M.H.)
| | - Michael Mayr
- Hypertension Clinic, Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (M.M.); (T.B.)
| | - Stefan Osswald
- Clinic of Cardiology, University Hospital Basel, 4031 Basel, Switzerland; (G.M.K.); (R.T.); (O.P.); (Q.Z.); (S.O.)
| | - Manuel Haschke
- Division of Clinical Pharmacology & Toxicology, University Hospital Basel, 4031 Basel, Switzerland; (A.V.); (S.K.); (M.H.)
- Division of Clinical Pharmacology & Toxicology, University Hospital Bern, 3010 Bern, Switzerland
| | - Thilo Burkard
- Hypertension Clinic, Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland; (M.M.); (T.B.)
- Clinic of Cardiology, University Hospital Basel, 4031 Basel, Switzerland; (G.M.K.); (R.T.); (O.P.); (Q.Z.); (S.O.)
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