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ARB treatment effect is short lived in individuals at risk for hypertension
17 July 2007
MedWire News: Individuals at high familial risk for hypertension treated with an angiotensin receptor blocker (ARB) have a reduction in blood pressure, but this positive effect does not persist when the treatment is withdrawn, Danish researchers report.
Essential hypertension remains the most common risk factor for cardiovascular morbidity and mortality. Preventing or delaying the onset of the disease may therefore have a large impact on public health, the team comments.
Karin Skov (University of Aarhus, Denmark) and colleagues randomly assigned 110 healthy normotensive individuals, aged 18 to 36 years, whose parents had essential hypertension, to receive 16 mg daily candesartan or placebo for 1 year.
In all, 48 individuals in the candesartan group and 53 in the placebo group completed the 2-year follow-up.
The primary outcome was a reduction in mean 24-hour ambulatory blood pressure (AMBP) recordings at 1 and 2 years of follow-up.
After 1 year of treatment, mean systolic and diastolic AMBP were significantly reduced in individuals treated with candesartan compared with those in the placebo group, with a change from baseline of −3.9/−3.4 mmHg systolic/diastolic AMBP for candesartan, and 0.3/0.6 mmHg with placebo (p<0.0001).
Patients in the candesartan group, unlike those receiving placebo, also had significantly reduced renal vascular resistance and left ventricular mass after 1 year of treatment (p=0.0007, p=0.019, respectively).
At 6, 12, and 24 months of follow-up, mean AMBP in the candesartan group was not different to that in the placebo group, with values similar to those at baseline.
The treatment was well tolerated, the team notes, and no significant differences in adverse events were found between the two groups.
Skov and co-workers conclude in the journal Hypertension: “During intervention, blood pressure, renal vascular resistance, and left ventricular mass were lowered.”
However, they add, in contradiction to results from animal studies, “treatment with an ARB had no persistent effect on blood pressure after the treatment was withdrawn.”
