Identifying treatment response to antihypertensives in patients with obesity-related hypertension

Ilse M Schrover, Jannick A N Dorresteijn, Jodine E Smits, A H Jan Danser, Frank L J Visseren, Wilko Spiering, Ilse M Schrover, Jannick A N Dorresteijn, Jodine E Smits, A H Jan Danser, Frank L J Visseren, Wilko Spiering

Abstract

Background: In patients with obesity-related hypertension (ORH), reaction to antihypertensive medication is likely influenced by patientcharacteristics.

Methods: Effects of aliskiren, moxonidine and hydrochlorothiazide on 24-h blood pressure (BP) were compared to placebo. Linear mixed effect models were used to analyze the effect of patient characteristics on BP levels and treatment response.

Results: Systolic BP response to aliskiren was higher in patients with a BMI > 30.7 kg/m2 compared to patients with a BMI ≤ 30.7 kg/m2 (-21 mmHg versus -4 mmHg). In patients with a hsCRP > 1.8 mg/L the systolic BP response to aliskiren was higher than in patients with a low hsCRP (-15 mmHg versus -7 mmHg). Hydrochlorothiazide (HCTZ) treatment effect on systolic BP was -13 mmHg when heart rate > 71 beats/min compared to -3 mmHg when heart rate was ≤ 71 beats/min.

Conclusion: In patients with ORH, BP response to aliskiren is positively related to BMI and hsCRP. Systolic BP response to HCTZ is positively related to heart rate and negatively to renin levels.

Trial registration: NCT01138423. Registered June 4th, 2010.

Keywords: Hypertension; Interaction; Obesity; Treatment.

Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This was judged by the Ethics Committee of the Universal Medical Center Utrecht, the Netherlands (reference number: 10-215/G-E).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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