Improvement of Plasma Biomarkers after Switching Stroke Patients from Other Angiotensin II Type I Receptor Blockers to Olmesartan

• Published in: Journal of stroke and cerebrovascular diseases 2015-07, Vol.24 (7), p.1487-1492
• Main Authors: Tada, Yoshiteru, MD, PhD, Yagi, Kenji, MD, PhD, Uno, Masaaki, MD, PhD, Matsushita, Nobuhisa, MD, PhD, Kanematsu, Yasuhisa, MD, PhD, Kuwayama, Kazuyuki, MD, PhD, Shimada, Kenji, MD, PhD, Nishi, Kyoko, MD, PhD, Hirasawa, Motohiro, MD, Satomi, Junichiro, MD, PhD, Kitazato, Keiko T., BS, Kageji, Teruyoshi, MD, PhD, Matsuura, Eiji, PhD, Nagahiro, Shinji, MD, PhD
• Format: Article
• Language: English
• Subjects: Adiponectin; Aged; Angiotensin I - blood; Angiotensin II Type 1 Receptor Blockers - adverse effects; Angiotensin II Type 1 Receptor Blockers - therapeutic use; angiotensin-(1-7); Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; beta 2-Glycoprotein I - blood; Biomarkers - blood; Blood Pressure - drug effects; Cardiovascular; Drug Substitution; Female; Humans; hypertension; Hypertension - blood; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - physiopathology; Japan; LDL/β-2-glycoprotein I complex; Lipoproteins, LDL - blood; Male; Middle Aged; Neurology; olmesartan; Olmesartan Medoxomil - adverse effects; Olmesartan Medoxomil - therapeutic use; Peptide Fragments - blood; peroxiredoxin; Peroxiredoxins - blood; Prospective Studies; Stroke - blood; Stroke - diagnosis; Stroke - drug therapy; Stroke - physiopathology; Time Factors; Treatment Outcome
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2015.03.015

Background Managing hypertension is crucial for preventing stroke recurrence. Some stroke patients experience resistant hypertension. In our experimental stroke model, olmesartan increased the expression of angiotensin (Ang) II converting enzyme-2. We hypothesized that switching to olmesartan affects biomarkers and the blood pressure (BP) in stroke patients whose BP is insufficiently controlled by standard doses of Ang II type I receptor blockers (ARBs) other than olmesartan. Methods We recruited 25 patients to study our hypothesis. All had a history of stroke or silent cerebral infarction. We switched them to olmesartan (10-40 mg per day) for 12 weeks and determined their plasma level of Ang-(1-7), peroxiredoxin, oxidized low-density lipoprotein (oxLDL)/β-2-glycoprotein I (β2GPI) complex, adiponectin, high mobility group box 1 (HMGB1), and tumor necrosis factor-α (TNFα) and recorded their BP before and after olmesartan treatment. Results After switching the patients to olmesartan, their plasma level of Ang-(1-7) as a vasoprotective indicator and adiponectin regulating metabolic syndrome was increased, and peroxiredoxin and the oxLDL/β2GPI complex indicating its antioxidative stress and its proatherogenicity were lower than their baseline. This suggests that olmesartan may be more effective than other ARBs to improve these conditions. Neither HMGB1 nor TNFα reflecting an inflammatory response was affected, suggesting that the anti-inflammatory effects of olmesartan are similar to those of other ARBs. The recommended BP (