Effects of valsartan on fibrinolysis in hypertensive patients with metabolic syndrome
Masaaki Miyata, Yoshiyuki Ikeda, Shuji Nakamura, Takeshi Sasaki, Satoshi Abe, Shinichi Minagoe, Hiroyuki Torii, Souki Lee, Shigeki Tateishi, Koichi Kihara, Ichiro Ohba, Shoko Kajiya, Yuko Furusho, Shuichi Hamasaki, Chuwa Tei, Kagoshima Collaborate Trial in Metabolic Syndrome (KACT-MetS) Investigators, Chuwa Tei, Shuichi Hamasaki, Masaaki Miyata, Yoshiyuki Ikeda, Yuko Furusho, Shuji Nakamura, Takeshi Sasaki, Munesumi Ishizawa, Satoshi Abe, Kiyoaki Yamamoto, Shoko Kajiya, Hitoshi Uenomachi, Souki Lee, Masakazu Imamura, Satoshi Yoshino, Takashi Kajiya, Shinichi Minagoe, Manabu Setoguchi, Kenshi Kumeta, Shin Kawasoe, Yasuhisa Iriki, Daisuke Nakamura, Shigeki Tateishi, Ichiro Ohba, Hideyuki Eto, Koichi Kihara, Masanori Tsurugida, Ryo Arikawa, Kazuhiro Anzaki, Kenzaburo Shiki, Hiroyuki Torii, Tsuyoshi Yamaguchi, Koji Shimomai, Atsushi Kuroda, Masahiko Saigo, Naoko Imamura, Yoshihiko Atsuchi, Hiroshi Yamaguchi, Akihiro Miyamura, Junichiro Takaoka, Hiroshi Yoshii, Hiroshi Arimura, Masaaki Miyata, Yoshiyuki Ikeda, Shuji Nakamura, Takeshi Sasaki, Satoshi Abe, Shinichi Minagoe, Hiroyuki Torii, Souki Lee, Shigeki Tateishi, Koichi Kihara, Ichiro Ohba, Shoko Kajiya, Yuko Furusho, Shuichi Hamasaki, Chuwa Tei, Kagoshima Collaborate Trial in Metabolic Syndrome (KACT-MetS) Investigators, Chuwa Tei, Shuichi Hamasaki, Masaaki Miyata, Yoshiyuki Ikeda, Yuko Furusho, Shuji Nakamura, Takeshi Sasaki, Munesumi Ishizawa, Satoshi Abe, Kiyoaki Yamamoto, Shoko Kajiya, Hitoshi Uenomachi, Souki Lee, Masakazu Imamura, Satoshi Yoshino, Takashi Kajiya, Shinichi Minagoe, Manabu Setoguchi, Kenshi Kumeta, Shin Kawasoe, Yasuhisa Iriki, Daisuke Nakamura, Shigeki Tateishi, Ichiro Ohba, Hideyuki Eto, Koichi Kihara, Masanori Tsurugida, Ryo Arikawa, Kazuhiro Anzaki, Kenzaburo Shiki, Hiroyuki Torii, Tsuyoshi Yamaguchi, Koji Shimomai, Atsushi Kuroda, Masahiko Saigo, Naoko Imamura, Yoshihiko Atsuchi, Hiroshi Yamaguchi, Akihiro Miyamura, Junichiro Takaoka, Hiroshi Yoshii, Hiroshi Arimura
Abstract
Background: The purpose of this study was to analyze the effect of valsartan on abnormal adipocyte metabolism and prothrombotic state in hypertensive patients with metabolic syndrome (MetS).
Methods and results: We conducted a multicenter, prospective, randomized, parallel-group controlled trial in 150 hypertensive patients with MetS. They were randomly assigned to receive either 80-160 mg valsartan per day (valsartan group, n=79) or other conventional treatment without a renin-angiotensin system (RAS) inhibitor (non-RAS inhibitor group, n=71). After 1 year, there were no significant differences between the 2 groups in the changes in systolic and diastolic blood pressures (valsartan: 153±15/86±15 to 138±16/77±12 mmHg; non-RAS inhibitor: 150±14/82±15 to 137±15/76±10 mmHg). There was a significant difference in the change in the levels of plasminogen activator inhibitor-1 (PAI-1) between the 2 groups after 1 year (valsartan: 3.7±3.2 ng/ml; non-RAS inhibitor: 5.8±3.3 ng/ml, P=0.04). There was no significant difference between groups in the change in the concentration of adiponectin after 1 year (valsartan: 0.3±0.4 µg/ml; non-RAS inhibitor: 0.9±0.4 µg/ml, P=0.22). The animal study showed aortic PAI-1 protein expression was reduced in double knockout mice of angiotensin II type 1a receptor and apolipoprotein E (apoE) compared with the apoE knockout mice.
Conclusions: Valsartan reduced plasma PAI-1 levels compared to non-RAS inhibitor in hypertensive patients with MetS, which suggests it may be useful for improving fibrinolytic function.
Trial registration: ClinicalTrials.gov NCT00790946.
Source: PubMed