Effects of ARB or ACE-Inhibitor Administration on Plasma Levels of Aldosterone and Adiponectin in Hypertension

• Nakamura Tetsuya

  Clinical Investigation and Research Unit, Gunma University Hospital

• Kawachi Kenji

  Gunma Aldosterone Study Group

• Saito Yuichiro

  Department of Medicine and Biological Science, Gunma University Graduate School of Medicine

• Saito Tomoko

  Clinical Investigation and Research Unit, Gunma University Hospital

• Morishita Koujurou

  Gunma Aldosterone Study Group

• Hoshino Jin

  Gunma Aldosterone Study Group

• Hosoi Tsutomu

  Gunma Aldosterone Study Group

• Iwasaki Tsutomu

  Gunma Aldosterone Study Group

• Ohyama Yoshio

  Gunma Aldosterone Study Group

• Kurabayashi Masahiko

  Department of Medicine and Biological Science, Gunma University Graduate School of Medicine

抄録

Aldosterone production causes vascular injury and may occur despite the long-term administration of angiotensin converting enzyme-inhibitors (ACE-I) (ie, aldosterone breakthrough). The angiotensin II receptor blocker (ARB) telmisartan can function as a ligand for peroxisome proliferator-activated receptor (PPAR) γ. Stimulation of PPAR γ has been demonstrated to raise adiponectin production and suppress angiotensin II type 1 receptor expression. Thus, we investigated the effect of the ACE-I perindopril erbumin (perindopril) and the ARB telmisartan on plasma levels of aldosterone and adiponectin.<br>Patients with essential hypertension were randomly assigned to receive 48 weeks of perindopril (2-8 mg/d) or telmisartan (20-80 mg/d). We measured adiponectin, aldosterone, angiotensin II, and renin at weeks 0, 8, 24, and 48.<br>A total of 53 subjects were randomized. Data on 51 subjects (25 in the perindopril group and 26 in the telmisartan group; mean age, 65.1 years) were available for analyses. Plasma aldosterone decreased significantly in both the telmisartan (69.9 ± 5.6 to 58.1 ± 5.4 pg/mL) and perindopril (74.1 ± 4.7 to 64.7 ± 5.3 pg/mL) groups at 8 weeks, but returned toward the baseline in the perindopril group (67.9 ± 4.1 pg/mL) at 24 weeks. Plasma glycated hemoglobin levels or urine albumin did not change significantly after the treatment in either group.<br>Telmisartan seemed to be more effective at suppressing aldosterone and raising adiponectin levels than perindopril; however, improvements in insulin sensitivity and albuminuria were not detected. These results are consistent with the idea that the use of an ARB with PPAR γ stimulating activity is equivalent to ACE-I for the treatment of hypertension.

収録刊行物

• International Heart Journal

  International Heart Journal 50 (4), 501-512, 2009

  一般社団法人 インターナショナル・ハート・ジャーナル刊行会

キーワード

• Leptin
• Renin
• Angiotensin
• Peroxisome proliferator-activated receptor

詳細情報

• CRID: 1390282680203206016
• NII論文ID: 130000120833
• DOI: 10.1536/ihj.50.501
• ISSN: 13493299
• ISSN: 13492365
• Web Site: http://www.jstage.jst.go.jp/article/ihj/50/4/50_4_501/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2010086091
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可