학술논문

Angiotensin-converting enzyme inhibition but not angiotensin II type 1 receptor antagonism augments coronary release of tissue plasminogen activator in hypertensive patients
Document Type
Journal Article
Source
Journal of the American College of Cardiology (JACC). Apr2003, Vol. 41 Issue 8, p1373-1379. 7p.
Subject
*ANGIOTENSIN converting enzyme
*CORONARY vasospasm
*ANGIOTENSINS
*ACE inhibitors
*CELL receptors
*CLINICAL trials
*COMPARATIVE studies
*CORONARY circulation
*DOSE-effect relationship in pharmacology
*FIBRINOLYSIS
*HYPERTENSION
*ANTIHYPERTENSIVE agents
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*TISSUE plasminogen activator
*VASODILATORS
*EVALUATION research
*RANDOMIZED controlled trials
*LOSARTAN
*ANGIOTENSIN receptors
*PHARMACODYNAMICS
Language
ISSN
0735-1097
Abstract
: ObjectivesWe compared the effects of perindopril and losartan on endothelium-dependent coronary vasomotor and fibrinolytic function.: BackgroundThe renin-angiotensin system regulates the vascular fibrinolytic balance. However, the effects of angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor antagonists on coronary fibrinolytic function have not been compared in hypertensive patients.: MethodsForty-five patients with hypertension were randomly assigned to three groups: 16 patients were treated with perindopril (4 mg/day) for four weeks; 15 were treated with losartan (50 mg/day) for four weeks; and 14 were not treated with either perindopril or losartan (control group). Graded doses of bradykinin (BK) (0.2, 0.6, and 2.0 μg/min) were administered into the left coronary artery. Coronary blood flow (CBF) was evaluated by Doppler flow velocity measurement.: ResultsBradykinin induced dose-dependent increases in CBF in all groups. The increases in CBF induced by BK in the perindopril and losartan groups were significantly greater than those in the control group. Net coronary tissue-type plasminogen activator (t-PA) release was enhanced by BK in all groups, and the increase in the perindopril group was greater than that in the losartan and control groups. Bradykinin did not alter plasminogen activator inhibitor type 1 levels in any of the groups.: ConclusionsPerindopril and losartan similarly augment BK-induced coronary vasodilation. Perindopril may have a greater potential to enhance the BK-induced coronary release of t-PA than losartan. [Copyright &y& Elsevier]