Effects of olmesartan medoxomil, an angiotensin II type 1 receptor antagonist, on plasma concentration of B-type natriuretic peptide, in hypertensive patients with type 2 diabetes mellitus

A preliminary, observational, open-label study

Toshihide Kawai, Izumi Takei, Akira Shimada, Takumi Hirata, Kumiko Tanaka, Yoshifumi Saisho, Junichiro Irie, Chihiro Horimai, Hideo Matsumoto, Hiroshi Itoh

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and Objective: Angiotensin II type 1 (AT1) receptor antagonists (angiotensin receptor blockers [ARBs]) are widely used for the treatment of not only hypertension but also cardiac dysfunction. B-type natriuretic peptide (BNP) is secreted mainly by the cardiac ventricle and plays an important role in the regulation of blood pressure (BP) and body fluid. It has been established that the plasma level of BNP is increased in patients with chronic heart failure in proportion to the severity of cardiac dysfunction. Because cardiac dysfunction is closely associated with a high risk of mortality in patients with diabetes mellitus, early identification and prevention of cardiac dysfunction are important. The objective of this study was to determine the effects of olmesartan medoxomil, a novel ARB, on the plasma level of BNP in hypertensive patients with type 2 diabetes. Methods: This was a preliminary, prospective, observational, open-label study. Sixty-eight type 2 diabetic patients with hypertension (systolic BP [SBP] ≥140 mmHg or diastolic BP [DBP] ≥90 mmHg) received olmesartan medoxomil 10-20mg/day for 24 weeks. Plasma levels of BNP, as well as several clinical parameters of glycaemic control and lipid metabolism, were compared before and after 24 weeks of treatment. Another group consisting of 22 ageand body mass index-matched subjects not treated with olmesartan medoxomil was observed for reference purposes. Results: In the olmesartan medoxomil group, mean±SD SBP decreased from 152.8±16.4 at baseline to 146.8±14.4 mmHg after 24 weeks' treatment (p < 0.05); similarly, mean±SD DBP decreased from 85.6±10.5 to 81.3±11.6 mmHg (p < 0.05). In 53 subjects in whom plasma levels of BNP could be measured both before and after treatment, mean±SD BNP decreased from 41.3±49.9 to 32.5±36.3 pg/mL (p < 0.05). Change in plasma BNP level over the 24-week treatment period in the olmesartan medoxomil group was not correlated with change in SBP or DBP. Multiple regression analysis revealed that change in plasma BNP level was not correlated with baseline value of or change in any other parameters. No other parameters in the olmesartan medoxomil group, and no parameters in the non-olmesartan medoxomil reference group, showed significant changes. Conclusion: The current preliminary study showed that olmesartan medoxomil treatment might decrease plasma BNP levels, independent of its BPlowering effect, in hypertensive patients with type 2 diabetes.

Original languageEnglish
Pages (from-to)237-245
Number of pages9
JournalClinical Drug Investigation
Volume31
Issue number4
DOIs
Publication statusPublished - 2011

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Angiotensin II Type 1 Receptor Blockers
Brain Natriuretic Peptide
Type 2 Diabetes Mellitus
Blood Pressure
Angiotensin Receptor Antagonists
Therapeutics
Hypertension
Olmesartan Medoxomil
Body Fluids
Lipid Metabolism
Heart Ventricles
Diabetes Mellitus
Body Mass Index
Heart Failure
Regression Analysis

Keywords

  • Angiotensin-type-1-receptor-antagonists, therapeutic use
  • Diabetes-mellitus
  • Hypertension, treatment
  • Olmesartan-medoxomil, therapeutic use

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

@article{acec3102618c402ca49f0ad3afeede54,
title = "Effects of olmesartan medoxomil, an angiotensin II type 1 receptor antagonist, on plasma concentration of B-type natriuretic peptide, in hypertensive patients with type 2 diabetes mellitus: A preliminary, observational, open-label study",
abstract = "Background and Objective: Angiotensin II type 1 (AT1) receptor antagonists (angiotensin receptor blockers [ARBs]) are widely used for the treatment of not only hypertension but also cardiac dysfunction. B-type natriuretic peptide (BNP) is secreted mainly by the cardiac ventricle and plays an important role in the regulation of blood pressure (BP) and body fluid. It has been established that the plasma level of BNP is increased in patients with chronic heart failure in proportion to the severity of cardiac dysfunction. Because cardiac dysfunction is closely associated with a high risk of mortality in patients with diabetes mellitus, early identification and prevention of cardiac dysfunction are important. The objective of this study was to determine the effects of olmesartan medoxomil, a novel ARB, on the plasma level of BNP in hypertensive patients with type 2 diabetes. Methods: This was a preliminary, prospective, observational, open-label study. Sixty-eight type 2 diabetic patients with hypertension (systolic BP [SBP] ≥140 mmHg or diastolic BP [DBP] ≥90 mmHg) received olmesartan medoxomil 10-20mg/day for 24 weeks. Plasma levels of BNP, as well as several clinical parameters of glycaemic control and lipid metabolism, were compared before and after 24 weeks of treatment. Another group consisting of 22 ageand body mass index-matched subjects not treated with olmesartan medoxomil was observed for reference purposes. Results: In the olmesartan medoxomil group, mean±SD SBP decreased from 152.8±16.4 at baseline to 146.8±14.4 mmHg after 24 weeks' treatment (p < 0.05); similarly, mean±SD DBP decreased from 85.6±10.5 to 81.3±11.6 mmHg (p < 0.05). In 53 subjects in whom plasma levels of BNP could be measured both before and after treatment, mean±SD BNP decreased from 41.3±49.9 to 32.5±36.3 pg/mL (p < 0.05). Change in plasma BNP level over the 24-week treatment period in the olmesartan medoxomil group was not correlated with change in SBP or DBP. Multiple regression analysis revealed that change in plasma BNP level was not correlated with baseline value of or change in any other parameters. No other parameters in the olmesartan medoxomil group, and no parameters in the non-olmesartan medoxomil reference group, showed significant changes. Conclusion: The current preliminary study showed that olmesartan medoxomil treatment might decrease plasma BNP levels, independent of its BPlowering effect, in hypertensive patients with type 2 diabetes.",
keywords = "Angiotensin-type-1-receptor-antagonists, therapeutic use, Diabetes-mellitus, Hypertension, treatment, Olmesartan-medoxomil, therapeutic use",
author = "Toshihide Kawai and Izumi Takei and Akira Shimada and Takumi Hirata and Kumiko Tanaka and Yoshifumi Saisho and Junichiro Irie and Chihiro Horimai and Hideo Matsumoto and Hiroshi Itoh",
year = "2011",
doi = "10.2165/11586510-000000000-00000",
language = "English",
volume = "31",
pages = "237--245",
journal = "Clinical Drug Investigation",
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TY - JOUR

T1 - Effects of olmesartan medoxomil, an angiotensin II type 1 receptor antagonist, on plasma concentration of B-type natriuretic peptide, in hypertensive patients with type 2 diabetes mellitus

T2 - A preliminary, observational, open-label study

AU - Kawai, Toshihide

AU - Takei, Izumi

AU - Shimada, Akira

AU - Hirata, Takumi

AU - Tanaka, Kumiko

AU - Saisho, Yoshifumi

AU - Irie, Junichiro

AU - Horimai, Chihiro

AU - Matsumoto, Hideo

AU - Itoh, Hiroshi

PY - 2011

Y1 - 2011

N2 - Background and Objective: Angiotensin II type 1 (AT1) receptor antagonists (angiotensin receptor blockers [ARBs]) are widely used for the treatment of not only hypertension but also cardiac dysfunction. B-type natriuretic peptide (BNP) is secreted mainly by the cardiac ventricle and plays an important role in the regulation of blood pressure (BP) and body fluid. It has been established that the plasma level of BNP is increased in patients with chronic heart failure in proportion to the severity of cardiac dysfunction. Because cardiac dysfunction is closely associated with a high risk of mortality in patients with diabetes mellitus, early identification and prevention of cardiac dysfunction are important. The objective of this study was to determine the effects of olmesartan medoxomil, a novel ARB, on the plasma level of BNP in hypertensive patients with type 2 diabetes. Methods: This was a preliminary, prospective, observational, open-label study. Sixty-eight type 2 diabetic patients with hypertension (systolic BP [SBP] ≥140 mmHg or diastolic BP [DBP] ≥90 mmHg) received olmesartan medoxomil 10-20mg/day for 24 weeks. Plasma levels of BNP, as well as several clinical parameters of glycaemic control and lipid metabolism, were compared before and after 24 weeks of treatment. Another group consisting of 22 ageand body mass index-matched subjects not treated with olmesartan medoxomil was observed for reference purposes. Results: In the olmesartan medoxomil group, mean±SD SBP decreased from 152.8±16.4 at baseline to 146.8±14.4 mmHg after 24 weeks' treatment (p < 0.05); similarly, mean±SD DBP decreased from 85.6±10.5 to 81.3±11.6 mmHg (p < 0.05). In 53 subjects in whom plasma levels of BNP could be measured both before and after treatment, mean±SD BNP decreased from 41.3±49.9 to 32.5±36.3 pg/mL (p < 0.05). Change in plasma BNP level over the 24-week treatment period in the olmesartan medoxomil group was not correlated with change in SBP or DBP. Multiple regression analysis revealed that change in plasma BNP level was not correlated with baseline value of or change in any other parameters. No other parameters in the olmesartan medoxomil group, and no parameters in the non-olmesartan medoxomil reference group, showed significant changes. Conclusion: The current preliminary study showed that olmesartan medoxomil treatment might decrease plasma BNP levels, independent of its BPlowering effect, in hypertensive patients with type 2 diabetes.

AB - Background and Objective: Angiotensin II type 1 (AT1) receptor antagonists (angiotensin receptor blockers [ARBs]) are widely used for the treatment of not only hypertension but also cardiac dysfunction. B-type natriuretic peptide (BNP) is secreted mainly by the cardiac ventricle and plays an important role in the regulation of blood pressure (BP) and body fluid. It has been established that the plasma level of BNP is increased in patients with chronic heart failure in proportion to the severity of cardiac dysfunction. Because cardiac dysfunction is closely associated with a high risk of mortality in patients with diabetes mellitus, early identification and prevention of cardiac dysfunction are important. The objective of this study was to determine the effects of olmesartan medoxomil, a novel ARB, on the plasma level of BNP in hypertensive patients with type 2 diabetes. Methods: This was a preliminary, prospective, observational, open-label study. Sixty-eight type 2 diabetic patients with hypertension (systolic BP [SBP] ≥140 mmHg or diastolic BP [DBP] ≥90 mmHg) received olmesartan medoxomil 10-20mg/day for 24 weeks. Plasma levels of BNP, as well as several clinical parameters of glycaemic control and lipid metabolism, were compared before and after 24 weeks of treatment. Another group consisting of 22 ageand body mass index-matched subjects not treated with olmesartan medoxomil was observed for reference purposes. Results: In the olmesartan medoxomil group, mean±SD SBP decreased from 152.8±16.4 at baseline to 146.8±14.4 mmHg after 24 weeks' treatment (p < 0.05); similarly, mean±SD DBP decreased from 85.6±10.5 to 81.3±11.6 mmHg (p < 0.05). In 53 subjects in whom plasma levels of BNP could be measured both before and after treatment, mean±SD BNP decreased from 41.3±49.9 to 32.5±36.3 pg/mL (p < 0.05). Change in plasma BNP level over the 24-week treatment period in the olmesartan medoxomil group was not correlated with change in SBP or DBP. Multiple regression analysis revealed that change in plasma BNP level was not correlated with baseline value of or change in any other parameters. No other parameters in the olmesartan medoxomil group, and no parameters in the non-olmesartan medoxomil reference group, showed significant changes. Conclusion: The current preliminary study showed that olmesartan medoxomil treatment might decrease plasma BNP levels, independent of its BPlowering effect, in hypertensive patients with type 2 diabetes.

KW - Angiotensin-type-1-receptor-antagonists, therapeutic use

KW - Diabetes-mellitus

KW - Hypertension, treatment

KW - Olmesartan-medoxomil, therapeutic use

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