scholarly journals Effect of angiotensin II receptor blocker therapy on markers of fibrosis and immune inflammation in hypertensive patients with chronic kidney disease after ischemic stroke

2021 ◽  
Vol 20 (7) ◽  
pp. 3078
Author(s):  
O. A. Osipova ◽  
E. V. Gosteva ◽  
O. N. Belousova ◽  
T. P. Golivets ◽  
J. Yu. Chefranova ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Ischemic Stroke ◽  
Angiotensin Ii ◽  
Kidney Disease ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Blocker Therapy ◽  
Hypertensive Patients ◽  
Tnf Α ◽  
Immune Inflammation

Aim. To compare the effect of angiotensin II receptor blocker therapy (azilsartan, telmisartan) on fibrosis and immune inflammation markers in hypertensive patients with chronic kidney disease (CKD) after ischemic stroke (IS).Material and methods. The study included 76 hypertensive patients aged 60-74 years (mean age, 66±5 years) with CKD after IS. Patients were randomly divided into following pharmacotherapy groups: 38 patients — telmisartan group; 36 patients — azilsartan group. The control group consisted of 20 hypertensive people (mean age, 63±2 years) without a history of CKD and IS. The levels of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were determined by enzyme-linked immunosorbent assay (ELISA Kit, USA). The levels of interleukin-1β (IL-1β), tumor necrosis factor α (TNF-α), interferon γ (INF-γ), monocytic chemoattractant protein 1 (MCP-1) were assessed using Vector-Best kit (Russia).Results. Six-month azilsartan therapy led to a decrease in the levels of MMP-9 by 19,9% (p<0,01), TIMP-1 by 7,5% (p<0,05), IL-1β by 7,8%, TNF-α by 13,5%, INF-γ by 7,1%, MCP-1 by 13% (p<0,05). Telmisartan therapy was associated with a decrease in the levels of MMP-9 by 39,1% (p<0,01), TIMP-1 by 16,4%, IL-1β by 10,1% (p<0,05), TNF-α by 20,8% (p<0,01), INF-γ by 14,6% (p<0,05), MCP-1 by 21,3% (p<0,01). Intergroup comparison revealed more pronounced changes in the levels of MMP-9 by 19,2% (p<0,01), TIMP-1 by 7,2% (p<0,05), TNF-α by 7,3% (p<0,05), INF-γ by 7,5% (p<0,05), and MCP-1 by 8,3% (p<0,05) when using telmisartan compared to azilsartan. When using telmisartan, the increase in glomerular filtration rate (GFR) was 14,2% (p<0,05) higher compared to azilsartan.Conclusion. Six-month telmisartan therapy in hypertensive patients with CKD after stroke was accompanied by a more pronounced decrease in markers of myocardial fibrosis (MMP-9, TIMP-1) and immune inflammation (TNF-α, INF-γ, MCP-1) compared with azilsartan, as well as with more pronounced improvement in renal function.

Abstract 854: Long-term Effects of Telmisartan, an Angiotensin II Receptor Blocker in Hypertensive Patients with Chronic Kidney Disease

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Hideki Watanabe ◽  
Kunio Nakagawa ◽  
Masaaki Kakihana
Keyword(s):  
Chronic Kidney Disease ◽  
Angiotensin Ii ◽  
Kidney Disease ◽  
Endothelial Function ◽  
Receptor Blocker ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
Hypertensive Patients ◽  
Amlodipine Group

Hypertension and Chronic Kidney Disease (CKD) is known as a major risk factor for cardiovascular disease (CVD). This study was designed to investigate endothelial function and long-term outcome of telmisartan, angiotensin II receptor blocker, in hypertensive patients with CKD. Seventy one untreated hypertensive patients with CKD (stage 3 or 4) were randomized to receive telmisartan ( Telmisartan group , n=35) or amlodipine ( Amlodipine group , n=36). Flow-mediated dilatation (FMD) and nitroglycerin-induced dilatation (NID) of brachial artery were measured by using ultrasound system. Pulse wave velocity (PWV) was measured by using oscilometric technique. We also measured high sensitivity C-reactive peptide (hsCRP) and thiobarbituric acid reactive substance (TBARS) as indexes of inflammation and oxidative stress. The primary outcome was death from CVD, or hospitalization for CVD during a follow-up period 4.2 to 4.7 years (median, 4.4 years). Blood pressure was significantly decreased in the both groups, and there was no difference between two groups at baseline and during study. FMD was significantly increased, and PWV, hsCRP, and TBARS were significantly decreased in the both groups after the treatment. However, these improvements were much better in the telmisartan group as compared with the amlodipine group. The 4.4-year cumulative primary-event rates were 12.6% in the telmisartan group and 37.4% in the amlodipine group (p=0.012 by long-lank test). Telmisartan improves not only endothelial function, PWV, hsCRP, or TBARS, but also long-term cardiovascular outcome in hypertensive patients with CKD.

scholarly journals Nephroprotective strategy in the treatment of hypertension as a modern general medical problem

2018 ◽  
pp. 107-118 ◽  
Author(s):  
V. I. Podzolkov ◽  
A. E. Bragina ◽  
T. I. Ishina ◽  
L. V. Bragina ◽  
L. V. Vasilyeva
Keyword(s):  
Chronic Kidney Disease ◽  
Angiotensin Ii ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Medical Problem ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
High Prevalence ◽  
Advanced Stages ◽  
Receptor Blockers

The current population is characterized by a high prevalence of risk factors for the development of chronic kidney disease: hypertension, diabetes, obesity, metabolic syndrome, physical inactivity, smoking. The development of severe complications and a close connection with potentially fatal cardiovascular disorders make this disease a socially and economically significant problem. Treatment of chronic kidney disease in advanced stages belong to nephrologist duties. However, the success of preventive interventions depends on the time of their onset, which makes it relevant to identify the disease. The use of nephroprotective approaches by physicians of different specialties (general practitioners, cardiologists, gerontologists, nephrologists, endocrinologists) can significantly improve the prognosis of both those at risk of developing renal dysfunction and the existing disease. The review presents data on the clinical and laboratory efficacy of angiotensin-renin blocker use, as well as the combination of angiotensin II receptor blockers with calcium antagonists. Using the combination of the angiotensin II receptor blocker irbesartan and amlodipine as an example, we demonstrated the possibilities of nephroprotective therapy in patients with renal dysfunction.

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