Effects of mono- and dual blockade of the renin-angiotensin system on markers of cardiovascular status in hypertensive patients with mild and moderate renal failure

Gábor Nagy, István A. Szijártó, Balázs Gaszner, Éva Lányi, Lajos Markó, Ákos Mérei, Gergo A. Molnár, Kinga Németh, József Betlehem, I. Wittmann

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background/Aims: Dual renin-angiotensin system (RAS) blockade has no more efficiency to decrease cardiovascular mortality than mono-blockade. Our goal was to explore differences between other cardiovascular markers in patients with RAS blockade. Methods: We analyzed two groups of patients treated with a long-term ACE inhibitor (MONO-group, n = 20) and an ACE inhibitor and angiotensin II receptor blocker (DUAL-group, n = 15). Ambulatory blood pressure monitoring, echocardiography, arterial stiffness and levels of catecholamine, endogenous ouabain (EO), pro-brain natriuretic peptide and more types of urinary albumin measurements were performed. Results: In the DUAL-group, we found significantly better cardiac parameters, but the levels of EO and urinary albumins were similar in both groups. The level of EO correlates with nighttime mean arterial blood pressure (R = 0.556, p = 0.032) and arterial β-stiffness (R = 0.512, p = 0.042). Urinary immuno-unreactive albumin showed a relationship with diastolic dysfunction of the heart (R = -0.508, p = 0.045) diurnal index of diastolic blood pressure (R = -0.569, p = 0.021) in the MONO-group. Conclusion: Cardiac parameters were more prosperous in the DUAL-group, but the levels of EO did not differ between groups. The level of EO correlated with blood pressure and arterial stiffness markers in the MONO-group only. The urinary immuno-unreactive albumin may be a new marker of cardiovascular conditions.

Original languageEnglish
Pages (from-to)150-157
Number of pages8
JournalKidney and Blood Pressure Research
Volume34
Issue number3
DOIs
Publication statusPublished - May 2011

Fingerprint

Ouabain
Renin-Angiotensin System
Renal Insufficiency
Vascular Stiffness
Albumins
Blood Pressure
Angiotensin-Converting Enzyme Inhibitors
Arterial Pressure
Ambulatory Blood Pressure Monitoring
Brain Natriuretic Peptide
Angiotensin Receptor Antagonists
Catecholamines
Echocardiography
Mortality

Keywords

  • Brain natriuretic peptide
  • Endogenous ouabain
  • Immuno-unreactive urinary albumin
  • Renal failure
  • Renin-angiotensin system blockade
  • Subclinical organ damage

ASJC Scopus subject areas

  • Nephrology
  • Cardiology and Cardiovascular Medicine

Cite this

Effects of mono- and dual blockade of the renin-angiotensin system on markers of cardiovascular status in hypertensive patients with mild and moderate renal failure. / Nagy, Gábor; Szijártó, István A.; Gaszner, Balázs; Lányi, Éva; Markó, Lajos; Mérei, Ákos; Molnár, Gergo A.; Németh, Kinga; Betlehem, József; Wittmann, I.

In: Kidney and Blood Pressure Research, Vol. 34, No. 3, 05.2011, p. 150-157.

Research output: Contribution to journalArticle

Nagy, Gábor ; Szijártó, István A. ; Gaszner, Balázs ; Lányi, Éva ; Markó, Lajos ; Mérei, Ákos ; Molnár, Gergo A. ; Németh, Kinga ; Betlehem, József ; Wittmann, I. / Effects of mono- and dual blockade of the renin-angiotensin system on markers of cardiovascular status in hypertensive patients with mild and moderate renal failure. In: Kidney and Blood Pressure Research. 2011 ; Vol. 34, No. 3. pp. 150-157.
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AU - Nagy, Gábor

AU - Szijártó, István A.

AU - Gaszner, Balázs

AU - Lányi, Éva

AU - Markó, Lajos

AU - Mérei, Ákos

AU - Molnár, Gergo A.

AU - Németh, Kinga

AU - Betlehem, József

AU - Wittmann, I.

PY - 2011/5

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N2 - Background/Aims: Dual renin-angiotensin system (RAS) blockade has no more efficiency to decrease cardiovascular mortality than mono-blockade. Our goal was to explore differences between other cardiovascular markers in patients with RAS blockade. Methods: We analyzed two groups of patients treated with a long-term ACE inhibitor (MONO-group, n = 20) and an ACE inhibitor and angiotensin II receptor blocker (DUAL-group, n = 15). Ambulatory blood pressure monitoring, echocardiography, arterial stiffness and levels of catecholamine, endogenous ouabain (EO), pro-brain natriuretic peptide and more types of urinary albumin measurements were performed. Results: In the DUAL-group, we found significantly better cardiac parameters, but the levels of EO and urinary albumins were similar in both groups. The level of EO correlates with nighttime mean arterial blood pressure (R = 0.556, p = 0.032) and arterial β-stiffness (R = 0.512, p = 0.042). Urinary immuno-unreactive albumin showed a relationship with diastolic dysfunction of the heart (R = -0.508, p = 0.045) diurnal index of diastolic blood pressure (R = -0.569, p = 0.021) in the MONO-group. Conclusion: Cardiac parameters were more prosperous in the DUAL-group, but the levels of EO did not differ between groups. The level of EO correlated with blood pressure and arterial stiffness markers in the MONO-group only. The urinary immuno-unreactive albumin may be a new marker of cardiovascular conditions.

AB - Background/Aims: Dual renin-angiotensin system (RAS) blockade has no more efficiency to decrease cardiovascular mortality than mono-blockade. Our goal was to explore differences between other cardiovascular markers in patients with RAS blockade. Methods: We analyzed two groups of patients treated with a long-term ACE inhibitor (MONO-group, n = 20) and an ACE inhibitor and angiotensin II receptor blocker (DUAL-group, n = 15). Ambulatory blood pressure monitoring, echocardiography, arterial stiffness and levels of catecholamine, endogenous ouabain (EO), pro-brain natriuretic peptide and more types of urinary albumin measurements were performed. Results: In the DUAL-group, we found significantly better cardiac parameters, but the levels of EO and urinary albumins were similar in both groups. The level of EO correlates with nighttime mean arterial blood pressure (R = 0.556, p = 0.032) and arterial β-stiffness (R = 0.512, p = 0.042). Urinary immuno-unreactive albumin showed a relationship with diastolic dysfunction of the heart (R = -0.508, p = 0.045) diurnal index of diastolic blood pressure (R = -0.569, p = 0.021) in the MONO-group. Conclusion: Cardiac parameters were more prosperous in the DUAL-group, but the levels of EO did not differ between groups. The level of EO correlated with blood pressure and arterial stiffness markers in the MONO-group only. The urinary immuno-unreactive albumin may be a new marker of cardiovascular conditions.

KW - Brain natriuretic peptide

KW - Endogenous ouabain

KW - Immuno-unreactive urinary albumin

KW - Renal failure

KW - Renin-angiotensin system blockade

KW - Subclinical organ damage

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