Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients
(1) Background: Recently, influences of antihypertensive treatment on the renin–angiotensin–aldosterone system (RAAS) has gained attention, regarding a possible influence on inflammatory and anti-inflammatory pathways. We aimed to study the effects of newly initiated antihypertensive drugs on angiot...
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MDPI AG
2021-03-01
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| author | Annina S. Vischer Gabriela M. Kuster Raphael Twerenbold Otmar Pfister Qian Zhou Andrea Villiger Marko Poglitsch Stephan Krähenbühl Michael Mayr Stefan Osswald Manuel Haschke Thilo Burkard |
| author_facet | Annina S. Vischer Gabriela M. Kuster Raphael Twerenbold Otmar Pfister Qian Zhou Andrea Villiger Marko Poglitsch Stephan Krähenbühl Michael Mayr Stefan Osswald Manuel Haschke Thilo Burkard |
| author_sort | Annina S. Vischer |
| collection | DOAJ |
| description | (1) Background: Recently, influences of antihypertensive treatment on the renin–angiotensin–aldosterone system (RAAS) has gained attention, regarding a possible influence on inflammatory and anti-inflammatory pathways. We aimed to study the effects of newly initiated antihypertensive drugs on angiotensin (Ang) II and Ang (1–7) as representers of two counter-regulatory axes. (2) Methods: In this randomized, open-label trial investigating RAAS peptides after the initiation of perindopril, olmesartan, amlodipine, or hydrochlorothiazide, Ang II and Ang (1–7) equilibrium concentrations were measured at 8 a.m. and 12 a.m. at baseline and after four weeks of treatment. Eighty patients were randomized (1:1:1:1 fashion). (3) Results: Between the four substances, we found significant differences regarding the concentrations of Ang II (<i>p</i> < 0.0005 for 8 a.m., 12 a.m.) and Ang (1–7) (<i>p</i> = 0.019 for 8 a.m., <0.0005 for 12 a.m.) four weeks after treatment start. Ang II was decreased by perindopril (<i>p</i> = 0.002), and increased by olmesartan (<i>p</i> < 0.0005), amlodipine (<i>p</i> = 0.012), and hydrochlorothiazide (<i>p</i> = 0.001). Ang (1–7) was increased by perindopril and olmesartan (<i>p</i> = 0.008/0.002), but not measurably altered by amlodipine and hydrochlorothiazide (<i>p</i> = 0.317/ 0.109). (4) Conclusion: The initiation of all first line antihypertensive treatments causes early and distinct alterations of equilibrium angiotensin levels. Given the additional AT1R blocking action of olmesartan, RAAS peptides shift upon initiation of perindopril and olmesartan appear to work in favor of the anti-inflammatory axis compared to amlodipine and hydrochlorothiazide. |
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| spelling | doaj.art-00ca764c554547c8bd07f1c6b1433d942023-12-03T12:19:57ZengMDPI AGCells2073-44092021-03-0110353410.3390/cells10030534Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive PatientsAnnina S. Vischer0Gabriela M. Kuster1Raphael Twerenbold2Otmar Pfister3Qian Zhou4Andrea Villiger5Marko Poglitsch6Stephan Krähenbühl7Michael Mayr8Stefan Osswald9Manuel Haschke10Thilo Burkard11Hypertension Clinic, Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, SwitzerlandClinic of Cardiology, University Hospital Basel, 4031 Basel, SwitzerlandClinic of Cardiology, University Hospital Basel, 4031 Basel, SwitzerlandClinic of Cardiology, University Hospital Basel, 4031 Basel, SwitzerlandClinic of Cardiology, University Hospital Basel, 4031 Basel, SwitzerlandDivision of Clinical Pharmacology & Toxicology, University Hospital Basel, 4031 Basel, SwitzerlandAttoquant Diagnostics GmbH, 1110 Vienna, AustriaDivision of Clinical Pharmacology & Toxicology, University Hospital Basel, 4031 Basel, SwitzerlandHypertension Clinic, Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, SwitzerlandClinic of Cardiology, University Hospital Basel, 4031 Basel, SwitzerlandDivision of Clinical Pharmacology & Toxicology, University Hospital Basel, 4031 Basel, SwitzerlandHypertension Clinic, Medical Outpatient Department and Hypertension Clinic, ESH Hypertension Centre of Excellence, University Hospital Basel, 4031 Basel, Switzerland(1) Background: Recently, influences of antihypertensive treatment on the renin–angiotensin–aldosterone system (RAAS) has gained attention, regarding a possible influence on inflammatory and anti-inflammatory pathways. We aimed to study the effects of newly initiated antihypertensive drugs on angiotensin (Ang) II and Ang (1–7) as representers of two counter-regulatory axes. (2) Methods: In this randomized, open-label trial investigating RAAS peptides after the initiation of perindopril, olmesartan, amlodipine, or hydrochlorothiazide, Ang II and Ang (1–7) equilibrium concentrations were measured at 8 a.m. and 12 a.m. at baseline and after four weeks of treatment. Eighty patients were randomized (1:1:1:1 fashion). (3) Results: Between the four substances, we found significant differences regarding the concentrations of Ang II (<i>p</i> < 0.0005 for 8 a.m., 12 a.m.) and Ang (1–7) (<i>p</i> = 0.019 for 8 a.m., <0.0005 for 12 a.m.) four weeks after treatment start. Ang II was decreased by perindopril (<i>p</i> = 0.002), and increased by olmesartan (<i>p</i> < 0.0005), amlodipine (<i>p</i> = 0.012), and hydrochlorothiazide (<i>p</i> = 0.001). Ang (1–7) was increased by perindopril and olmesartan (<i>p</i> = 0.008/0.002), but not measurably altered by amlodipine and hydrochlorothiazide (<i>p</i> = 0.317/ 0.109). (4) Conclusion: The initiation of all first line antihypertensive treatments causes early and distinct alterations of equilibrium angiotensin levels. Given the additional AT1R blocking action of olmesartan, RAAS peptides shift upon initiation of perindopril and olmesartan appear to work in favor of the anti-inflammatory axis compared to amlodipine and hydrochlorothiazide.https://www.mdpi.com/2073-4409/10/3/534arterial hypertensionrenin–angiotensin–aldosterone systemantihypertensive drugangiotensin-converting-enzyme inhibitorangiotensin receptor antagonistcalcium channel blocker |
| spellingShingle | Annina S. Vischer Gabriela M. Kuster Raphael Twerenbold Otmar Pfister Qian Zhou Andrea Villiger Marko Poglitsch Stephan Krähenbühl Michael Mayr Stefan Osswald Manuel Haschke Thilo Burkard Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients Cells arterial hypertension renin–angiotensin–aldosterone system antihypertensive drug angiotensin-converting-enzyme inhibitor angiotensin receptor antagonist calcium channel blocker |
| title | Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients |
| title_full | Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients |
| title_fullStr | Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients |
| title_full_unstemmed | Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients |
| title_short | Influence of Antihypertensive Treatment on RAAS Peptides in Newly Diagnosed Hypertensive Patients |
| title_sort | influence of antihypertensive treatment on raas peptides in newly diagnosed hypertensive patients |
| topic | arterial hypertension renin–angiotensin–aldosterone system antihypertensive drug angiotensin-converting-enzyme inhibitor angiotensin receptor antagonist calcium channel blocker |
| url | https://www.mdpi.com/2073-4409/10/3/534 |
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