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Protective Efect Of Olmesartan Medoxomil On Vascular Endothelial Function In Patients With Mild To Moderate Primary Hypertension And Its Stable Antihypertensive Effect

Posted on:2010-12-28Degree:MasterType:Thesis
Country:ChinaCandidate:X Q LangFull Text:PDF
GTID:2144360275461508Subject:Internal Medicine
Abstract/Summary:PDF Full Text Request
Objective The aim of the object was to study the protective effect of olmesartan medoxomil on vascular endothelial function in patients with mild to moderate primary hypertension and its stable antihypertensive effect.Hepatocyte growth factor (HGF) plays a crucial role on impaired function, and is related to prevalence, severity and target organ damages of cardiovascular diseases.Methods (1)Fifty patients with mild to moderate essential hypertension were randomized into two groups:(1)olmesartan group (n=25),received olmesartan 20mg/day; (2)candesartan group(n=25),8mg/day.Before and after the 8 weeks treatment, blood and urinary laboratory exanination,and blood pressure levels were observed in EH cases;all the subjects were measured by 24h ambulatory blood pressure mornitoring(ABPM),and moothness index were calculated from ambulatory blood pressure recordings.(2)Before and after the 8 weeks treatment, PA I-1, hs-CRP were observed in all subjects;(3)Serum HGF,plasma ET and serum NO were determined in olmesartan group (n= 50),be-fore and after 8- week treatment,;In the meantime, 25 normal persons were taken as control group. The hypertension criteria formulated by 1999 World Health Organization / International Society of Hypertension (WHO / ISH).Result 1.bloodpressure study(1)After 8 weeks treatment the systolic and diastolic blood pressure were decreased ( P< 0.01) in all of the cases, and the morning bloodpressure were lower than that before(P<0.05),but there was little distinct between the two groups,.omelsartan was more effective( P < 0. 01) .Adverse reactions were not observed in the two groups.(2)smoothness index in hypertension group is significantly higher after 8-week treatment (P<0.05),but is still lower than that in normotension group(P<0.01).(3)The effective power olmesartan group is 84%,and candesartan groupis 80%(P>0.05).2.vascular endothelium benefits(1) The PA I-1 and hs-CRP in EH cases were obviously higher than those in control group (P< 0.01) ;PA I-1 and hs-CRP were decreased ( P < 0.01) after treatment , but still higher than normal persons'(P<0.01) , and there was little distinct between the two groups(P>0.05). (2)Compared with normal persons,the blood NO is lower(P<0.05),both ET and HGF is higher(P<0.05)in hypertension group ; HGF have a positive correlation with ET(r=0.610, P<0.05), and negative correlation with NO(r=-0.617, P<0.05)(3) At the end of 8-week treatment of olmesartan medoxomil , blood NO is higher(P<0.05),both ET and HGF is lower (P<0.05), ,but all are higher than normal persons'(P<0.01).3.Side effectsThe incidence of study drug related adverse elvents in olmesartan group is 4% and is similar as that in candesartan group(8%,p>0.05). During the treatment ,there is litter side effect,and the routine inspection has not seen exceptionally.Conclusion1. Olmesartan is effective and safe to mild to moderate essential hypertension cases,;can improve the endothelial function and increase the smoothness index,and have the stable antihypertensive effect ;Olmesartan is similar to candesartan in hypotension effects.2.The presence of endothelial dysfunction is common in hypertensive patients ,and pressure variability is hingher than normotension group ; Olmesartan can improve the endothelia fountion.3. HGF can be looked as a protection factor to endothelial cell.
Keywords/Search Tags:olmesartan medoxomil, Hepatocyte growth factor, Endothelin, Nitricoxide, Smoothness
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