Feasibility of regression of hypertension using contemporary antihypertensive agents

Hiroyuki Sasamura, Hideaki Nakaya, Stevo Julius, Naoki Tomotsugu, Yuji Sato, Fumiaki Takahashi, Masahiro Takeuchi, Marohito Murakami, Munekazu Ryuzaki, Hiroshi Itoh

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background Recently, we reported that transient treatment of genetically hypertensive rats with high-dose angiotensin receptor blocker (ARB) causes regression of established hypertension. In this study, we investigated whether treatment with candesartan or nifedipine controlled-release (CR) resulted in a sustained regression of hypertension in humans. methods Patients aged 30 to 59 years with untreated stage 1 essential hypertension and a family history of hypertension were treated with the antihypertensive agents candesartan (n = 124) or nifedipine CR (n = 120). After 1 year of treatment (phase 1), the medications were tapered and discontinued (phase 2). During phase 2, home and office blood pressures were monitored for another year to assess posttreatment reoccurrence of stage 1 hypertension. results In phase 1, after 1 year of treatment a similarly substantial BP decrease was seen in the candesartan (-24.5/16.1 mm Hg) and nifedipine (-26.8/18.0 mm Hg) groups. In phase 2 there was a substantial reoccurrence of hypertension; at the study end, only 1 patient was able to continue without antihypertensive medication. However, a Kaplan-Meier analysis revealed a significant delay of reoccurrence of hypertension (P = 0.0001) in the candesartan group. conclusions One year of treatment with candesartan or nifedipine CR was not associated with marked regression of hypertension in humans at the standard doses used in this trial. However, withdrawal of candesartan was associated with a slightly longer delay before restarting medications. Further studies with larger doses of candesartan given over a longer time are required to determine whether such a regimen may induce sustainable and clinically relevant reversal of hypertension and alteration in its natural history.

Original languageEnglish
Pages (from-to)1381-1388
Number of pages8
JournalAmerican Journal of Hypertension
Volume26
Issue number12
DOIs
Publication statusPublished - 2013 Dec

    Fingerprint

Keywords

  • Angiotensin receptor blocker
  • Blood pressure
  • Calcium channel blocker
  • Essential hypertension
  • Hypertension
  • Regression

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Sasamura, H., Nakaya, H., Julius, S., Tomotsugu, N., Sato, Y., Takahashi, F., Takeuchi, M., Murakami, M., Ryuzaki, M., & Itoh, H. (2013). Feasibility of regression of hypertension using contemporary antihypertensive agents. American Journal of Hypertension, 26(12), 1381-1388. https://doi.org/10.1093/ajh/hpt105