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ABSTRACT: The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study showed that losartan-based treatment reduced risk of the composite endpoint of cardiovascular death, stroke and myocardial infarction compared with atenolol-based treatment in patients with hypertension and left ventricular hypertrophy with similar office blood pressure (BP) reduction. Our aim was to investigate the effect of losartan- and atenolol-based treatment on 24-h ambulatory BP and heart rate (HR) in LIFE.
In 110 patients, 24-h ambulatory BP and heart rate were recorded at baseline and 1 year after randomization.
Ambulatory BP was comparably reduced throughout the 24-h period after 1 year of losartan- vs atenolol-based antihypertensive treatment. Office and ambulatory BP were comparably reduced in the follow-up period. Early morning surge in BP was similar between groups. Non-dipping status was more frequent in the losartan group (p = 0.01). From baseline to Year 1 the 24-h HR profile for the losartan group was unchanged, but, as expected, there was a significant decrease in daytime HR in the atenolol group, which was not as large during early night-time.
There were no differences in 24-h BP burden and HR that could explain the difference in outcome in favor of losartan vs atenolol in the LIFE study.
Blood Pressure 02/2007; 16(6):392-7. · 1.43 Impact Factor
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Marina K Christensen,
Michael H Olsen,
Kristian Wachtell, Christian Tuxen,
Eigil Fossum,
Lia E Bang,
Niels Wiinberg,
Richard B Devereux,
Sverre E Kjeldsen,
Per Hildebrandt,
Jens Rokkedal,
Hans Ibsen
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ABSTRACT: The aim of this study was to investigate the effects of losartan- vs atenolol-based antihypertensive treatment on circulating collagen markers beyond the initial blood pressure (BP) reduction.
In 204 patients with hypertension and left ventricular (LV) hypertrophy we measured serum concentration of carboxy-terminal telopeptide of type I procollagen (ICTP), carboxy-terminal propeptide of type I procollagen (PICP), amino-terminal propeptide of type III procollagen (PIIINP), amino-terminal propeptide of type I procollagen (PINP) and LV mass by echocardiography at baseline and annually during 4 years of losartan- or atenolol-based antihypertensive treatment; 185 patients completed the study.
Beyond the first year of treatment systolic and diastolic BP, LV mass index (LVMI) as well as collagen markers did not change significantly and were equal in the two treatment groups. Changes in PICP during first year of treatment were related to subsequent changes in LV mass index after 2 and 3 years of treatment (r=0.28 and r=0.29, both p<0.05) in patients randomized to losartan, but not atenolol.
Long-term losartan- vs atenolol-based antihypertensive treatment did not influence collagen markers differently, making a BP-independent effect of losartan on collagen markers unlikely. However, initial reduction in circulating PICP may predict later regression of LV hypertrophy during losartan-based antihypertensive treatment.
Blood Pressure 01/2006; 15(4):198-206. · 1.43 Impact Factor
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ABSTRACT: Secretion of natriuretic peptides is related to cardiac wall stress and influenced by the renin-angiotensin system. Therefore, we investigated the influence of blood pressure (BP) reduction with losartan versus atenolol on N-terminal pro-atrial natriuretic peptide (Nt-proANP) and N-terminal pro-brain natriuretic peptide (Nt-proBNP).
In 183 patients with hypertension and electrocardiographic left ventricular (LV) hypertrophy, enrolled in the LIFE Study, we measured BP and serum Nt-proANP and Nt-proBNP by immunoassay after 2 weeks of placebo treatment and after 1, 2, 4, 6, 12, 24, 36 and 48 months of randomized treatment with losartan- or atenolol-based antihypertensive regimens.
There was no significant difference in BP at any time point between the two treatment groups. In patients treated with losartan, median Nt-proANP decreased gradually throughout the study, reaching significance after 6 months of treatment (1125-1060 pmol/l, P < 0.001), and Nt-proBNP decreased within the first month (24.7-18.7 pmol/l, P < 0.01) and stayed reduced throughout the study. During losartan-based antihypertensive treatment, Nt-proANP and Nt-proBNP as a percentage of baseline values were correlated to reductions in systolic BP (r = 0.11, P < 0.01 and r = 0.10, P = 0.01) and diastolic BP (r = 0.17, P < 0.001 and r = 0.07, P = 0.09). In atenolol-treated patients, Nt-proANP (1100-1640 pmol/l, P < 0.001) and Nt-proBNP (20.0-37.7 pmol/l, P < 0.001) increased during the first month, and remained elevated throughout the study. During atenolol-based antihypertensive treatment, changes in Nt-proANP (r = -0.16, P < 0.001) and Nt-proBNP (r = -0.07, P = 0.08) were negatively related to change in heart rate.
Nt-proANP and Nt-proBNP were reduced in parallel with BP in losartan-treated patients whereas they increased in parallel with decreased heart rate in atenolol-treated patients.
Journal of Hypertension 06/2005; 23(5):1083-90. · 4.02 Impact Factor
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ABSTRACT: N-terminal pro-brain natriuretic peptide (Nt-proBNP) and N-terminal pro-atrial natriuretic peptide (Nt-proANP) are strong cardiovascular risk markers in patients with chronic heart failure, as well as in the general population. We investigated whether high Nt-proBNP or Nt-proANP could also predict the composite endpoint (CEP) of cardiovascular death, non-fatal stroke or non-fatal myocardial infarction in patients with hypertension and left ventricular (LV) hypertrophy.
After 2 weeks of placebo treatment, clinical, laboratory and echocardiographic variables were assessed in 183 hypertensive participants in the LIFE echo substudy with electrocardiographic LV hypertrophy. Nt-proBNP and Nt-proANP were measured by immunoassay at baseline. The patients were followed for 60 +/- 5 months.
Using Cox regression analysis, the 25 CEP were predicted by ln(Nt-proBNP) (hazard ratio 1.61 per 2.73-fold increase, P < 0.01) as well as ln(Nt-proANP) (hazard ratio 2.93, P < 0.05). Nt-proBNP above the median value of 21.8 pmol/ml was associated with higher incidence of CEP (19.6 versus 7.7%, P < 0.05). Nt-proBNP above the median value was associated with higher incidence of CEP in the 123 patients without history of diabetes or cardiovascular disease (14.8 versus 4.3%, P < 0.05), but the association was insignificant in the 60 patients with a history of diabetes or cardiovascular disease (26.3 versus 18.2%, NS). Nt-proANP showed the same tendency.
Nt-proBNP, more than Nt-proANP, strongly predicts cardiovascular events in patients with hypertension and LV hypertrophy, especially in patients without diabetes or clinically overt cardiovascular disease.
Journal of Hypertension 08/2004; 22(8):1597-604. · 4.02 Impact Factor
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ABSTRACT: Am J Hypertens (2004) 17, 136A–137A; doi: 10.1016/j.amjhyper.2004.03.362
P-287: Brachial artery compliance and neurohormones in hypertension accompanied by left ventricular hypertrophy. A life study
Christian Tuxen1, Niels Wiinberg1, Per R. Hildebrandt1 and Jesper Mehlsen11Dept. of Cardiology, Frederiksberg University Hospital, Copenhagen, Denmark; Dept. of Clinical Physiology, Frederiksberg University Hospital, Copenhagen, Denmark.
American Journal of Hypertension 04/2004; · 3.18 Impact Factor
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ABSTRACT: Am J Hypertens (2004) 17, 187A–187A; doi: 10.1016/j.amjhyper.2004.03.494
P-420: Effect of atenolol and losartan on 24-hour ambulatory blood pressure in patients with hypertension: A life substudy
Niels Wiinberg1, Lia E. Bang1, Kristian Wachtell1, John Larsen1, Christian Tuxen1, Michael H. Olsen1, Hans Ibsen1 and Per R. Hildebrandt11Clinical Physiology, Frederiksberg University Hospital; Cardiology, Næstved Hospital; Cardiology, Glostrup University Hospital, Denmark
American Journal of Hypertension 04/2004; · 3.18 Impact Factor
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ABSTRACT: Am J Hypertens (2001) 14, 123A–123A; doi:10.1016/S0895-7061(01)01454-6
P-283: Compliance of peripheral conduit arteries is increased in isolated systolic hypertension accompanied by left ventricular hypertrophy, a life-substudy
Niels Wiinberg1, Christian Tuxen1, Jesper Mehlsen1 and Per Hildebrandt11Dept of Clinical Physiology and Cardiology Frederiksberg University Hospital, Frederiksberg, Copenhagen, Denmark
American Journal of Hypertension 03/2001; · 3.18 Impact Factor
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