Low doses of losartan and trandolapril improve arterial stiffness in hemodialysis patients

Atsuhiro Ichihara, Matsuhiko Hayashi, Yuki Kaneshiro, Tomoko Takemitsu, Koichiro Honma, Yoshihiko Kanno, Mamoru Yoshizawa, Tomohiro Furukawa, Tsuneo Takenaka, Takao Saruta

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

• Background: Hemodialysis patients have uremic dyslipidemia, represented by elevated serum intermediate-density lipoprotein cholesterol (IDL-C) levels, and an increased cardiovascular mortality rate. This study was performed to determine the low-dose effects of the angiotensin II receptor blocker losartan and the angiotensin-converting enzyme inhibitor trandolapril on pulse wave velocity (PWV), which predicts cardiovascular morbidity and mortality in hemodialysis patients. Methods: Serum lipid levels and PWV were monitored for 12 months in 64 hemodialysis patients who were administered low doses of losartan or trandolapril or a placebo. Results: At the start of the study, there were no differences in patient characteristics among the 3 groups. PWV tended to increase in the placebo group during the 12-month study period, but decreased significantly in the losartan and trandolapril groups, and decreases in PWV were similar in the losartan and trandolapril groups. There were no changes in blood pressure, hematocrit, erythropoietin dose, ankle-brachial index, serum lipid levels, serum 8-isoprostane levels, or serum C-reactive protein levels during the 12-month study period, but there was an increase in serum triglyceride levels in the losartan group and a decrease in serum IDL-C levels in the losartan and trandolapril groups. Conclusion: In hemodialysis patients, trandolapril is as effective as losartan in decreasing PWV independent of its depressor effect and in suppressing elevated IDL-C levels. Long-term blockade of the renin-angiotensin system may have a beneficial effect on the acceleration of atherosclerosis and uremic dyslipidemia.

Original languageEnglish
Pages (from-to)866-874
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume45
Issue number5
DOIs
Publication statusPublished - 2005 May
Externally publishedYes

Fingerprint

trandolapril
Vascular Stiffness
Losartan
Renal Dialysis
Pulse Wave Analysis
Serum
8-epi-prostaglandin F2alpha
Dyslipidemias
Placebos
Lipids
Ankle Brachial Index
Mortality
Angiotensin Receptor Antagonists
Renin-Angiotensin System
Erythropoietin
Hematocrit
Angiotensin-Converting Enzyme Inhibitors
C-Reactive Protein
Blood Proteins

Keywords

  • End-stage renal disease (ESRD)
  • Lipoproteins
  • Losartan
  • Pulse wave velocity (PWV)
  • Trandolapril

ASJC Scopus subject areas

  • Nephrology

Cite this

Low doses of losartan and trandolapril improve arterial stiffness in hemodialysis patients. / Ichihara, Atsuhiro; Hayashi, Matsuhiko; Kaneshiro, Yuki; Takemitsu, Tomoko; Honma, Koichiro; Kanno, Yoshihiko; Yoshizawa, Mamoru; Furukawa, Tomohiro; Takenaka, Tsuneo; Saruta, Takao.

In: American Journal of Kidney Diseases, Vol. 45, No. 5, 05.2005, p. 866-874.

Research output: Contribution to journalArticle

Ichihara, A, Hayashi, M, Kaneshiro, Y, Takemitsu, T, Honma, K, Kanno, Y, Yoshizawa, M, Furukawa, T, Takenaka, T & Saruta, T 2005, 'Low doses of losartan and trandolapril improve arterial stiffness in hemodialysis patients', American Journal of Kidney Diseases, vol. 45, no. 5, pp. 866-874. https://doi.org/10.1053/j.ajkd.2005.02.022
Ichihara, Atsuhiro ; Hayashi, Matsuhiko ; Kaneshiro, Yuki ; Takemitsu, Tomoko ; Honma, Koichiro ; Kanno, Yoshihiko ; Yoshizawa, Mamoru ; Furukawa, Tomohiro ; Takenaka, Tsuneo ; Saruta, Takao. / Low doses of losartan and trandolapril improve arterial stiffness in hemodialysis patients. In: American Journal of Kidney Diseases. 2005 ; Vol. 45, No. 5. pp. 866-874.
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abstract = "• Background: Hemodialysis patients have uremic dyslipidemia, represented by elevated serum intermediate-density lipoprotein cholesterol (IDL-C) levels, and an increased cardiovascular mortality rate. This study was performed to determine the low-dose effects of the angiotensin II receptor blocker losartan and the angiotensin-converting enzyme inhibitor trandolapril on pulse wave velocity (PWV), which predicts cardiovascular morbidity and mortality in hemodialysis patients. Methods: Serum lipid levels and PWV were monitored for 12 months in 64 hemodialysis patients who were administered low doses of losartan or trandolapril or a placebo. Results: At the start of the study, there were no differences in patient characteristics among the 3 groups. PWV tended to increase in the placebo group during the 12-month study period, but decreased significantly in the losartan and trandolapril groups, and decreases in PWV were similar in the losartan and trandolapril groups. There were no changes in blood pressure, hematocrit, erythropoietin dose, ankle-brachial index, serum lipid levels, serum 8-isoprostane levels, or serum C-reactive protein levels during the 12-month study period, but there was an increase in serum triglyceride levels in the losartan group and a decrease in serum IDL-C levels in the losartan and trandolapril groups. Conclusion: In hemodialysis patients, trandolapril is as effective as losartan in decreasing PWV independent of its depressor effect and in suppressing elevated IDL-C levels. Long-term blockade of the renin-angiotensin system may have a beneficial effect on the acceleration of atherosclerosis and uremic dyslipidemia.",
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AU - Ichihara, Atsuhiro

AU - Hayashi, Matsuhiko

AU - Kaneshiro, Yuki

AU - Takemitsu, Tomoko

AU - Honma, Koichiro

AU - Kanno, Yoshihiko

AU - Yoshizawa, Mamoru

AU - Furukawa, Tomohiro

AU - Takenaka, Tsuneo

AU - Saruta, Takao

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N2 - • Background: Hemodialysis patients have uremic dyslipidemia, represented by elevated serum intermediate-density lipoprotein cholesterol (IDL-C) levels, and an increased cardiovascular mortality rate. This study was performed to determine the low-dose effects of the angiotensin II receptor blocker losartan and the angiotensin-converting enzyme inhibitor trandolapril on pulse wave velocity (PWV), which predicts cardiovascular morbidity and mortality in hemodialysis patients. Methods: Serum lipid levels and PWV were monitored for 12 months in 64 hemodialysis patients who were administered low doses of losartan or trandolapril or a placebo. Results: At the start of the study, there were no differences in patient characteristics among the 3 groups. PWV tended to increase in the placebo group during the 12-month study period, but decreased significantly in the losartan and trandolapril groups, and decreases in PWV were similar in the losartan and trandolapril groups. There were no changes in blood pressure, hematocrit, erythropoietin dose, ankle-brachial index, serum lipid levels, serum 8-isoprostane levels, or serum C-reactive protein levels during the 12-month study period, but there was an increase in serum triglyceride levels in the losartan group and a decrease in serum IDL-C levels in the losartan and trandolapril groups. Conclusion: In hemodialysis patients, trandolapril is as effective as losartan in decreasing PWV independent of its depressor effect and in suppressing elevated IDL-C levels. Long-term blockade of the renin-angiotensin system may have a beneficial effect on the acceleration of atherosclerosis and uremic dyslipidemia.

AB - • Background: Hemodialysis patients have uremic dyslipidemia, represented by elevated serum intermediate-density lipoprotein cholesterol (IDL-C) levels, and an increased cardiovascular mortality rate. This study was performed to determine the low-dose effects of the angiotensin II receptor blocker losartan and the angiotensin-converting enzyme inhibitor trandolapril on pulse wave velocity (PWV), which predicts cardiovascular morbidity and mortality in hemodialysis patients. Methods: Serum lipid levels and PWV were monitored for 12 months in 64 hemodialysis patients who were administered low doses of losartan or trandolapril or a placebo. Results: At the start of the study, there were no differences in patient characteristics among the 3 groups. PWV tended to increase in the placebo group during the 12-month study period, but decreased significantly in the losartan and trandolapril groups, and decreases in PWV were similar in the losartan and trandolapril groups. There were no changes in blood pressure, hematocrit, erythropoietin dose, ankle-brachial index, serum lipid levels, serum 8-isoprostane levels, or serum C-reactive protein levels during the 12-month study period, but there was an increase in serum triglyceride levels in the losartan group and a decrease in serum IDL-C levels in the losartan and trandolapril groups. Conclusion: In hemodialysis patients, trandolapril is as effective as losartan in decreasing PWV independent of its depressor effect and in suppressing elevated IDL-C levels. Long-term blockade of the renin-angiotensin system may have a beneficial effect on the acceleration of atherosclerosis and uremic dyslipidemia.

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KW - Lipoproteins

KW - Losartan

KW - Pulse wave velocity (PWV)

KW - Trandolapril

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