18465
document
A double blind randomized trial to compare the effects of eprosartan and enalapril on blood pressure , platelets , and endothelium function in patients with essential hypertension . The renin-angiotensin system is the major contributor to development of hypertension , atherosclerosis , and many other cardiovascular diseases . Angiotensin II , one of the main effectors of this system , contributes to the pathogenesis of hypertension and plays an important role in monocyte , platelet , and endothelium interactions . The effects on platelet and endothelial function , either by angiotensin converting enzyme inhibitors or angiotensin receptor antagonists , are still not well understood . A double-blind , randomized , prospective trial of either enalapril ( 10-20 mg daily ) or eprosartan ( 400-800 mg daily ) over a 10-week period was conducted in 42 patients ( 27 males , 15 females ) . Platelet activation was evaluated by measuring platelet factor 4 ( PF-4 ) , beta-thromboglobulin ( beta-TG ) , the ratio of platelet factor 4 to beta-thromboglobulin , and endothelial function by measuring total plasma nitrate levels , von Willebrand factor ( vWF ) levels , and blood flow using venous occlusive plethysmography . After a 10-week treatment with enalapril or eprosartan , the sitting blood pressure in both the enalapril group ( from 152.2 +/- 18.7 mmHg to 141.9 +/- 23.5 mmHg , P < 0.05 ) and eprosartan group ( from 151 +/- 10.0 mmHg to 142.3 +/- 12.9 mmHg , P < 0.05 ) was significantly reduced . Significant diastolic blood pressure ( DPB ) reduction ( from 94 +/- 8.7 to 84.5 +/- 9.6 mmHg , P < 0.05 ) and a greater DBP reduction response were found in the eprosartan group ( 63 % in eprosartan versus 25 % in enalapril ) . Additionally , dose-dependent reductions in the indices of platelet activation and endothelial dysfunction were observed in patients administered high dose treatments of eprosartan and enalapril , and the beneficial effects of these agents were not correlated with the reduction of blood pressure using both agents . Eprosartan is effective and well-tolerated in the treatment of mid-to-moderate hypertension , and the DBP response reduction to eprosartin was better than that to enalapril . A high dose of either eprosartan or enalapril significantly decreased the indices of platelet activation and endothelial dysfunction in hypertensive patients . The benefits of both agents can not be explained solely by their antihypertensive effects and possibly may be mediated through their unique effect on angiotensin blockade .
18466
Intervention_Pharmacological
eprosartan and enalapril
18467
Intervention_Pharmacological
enalapril
18468
Intervention_Pharmacological
eprosartan
18469
Intervention_Pharmacological
enalapril or eprosartan
18470
Intervention_Pharmacological
enalapril
18471
Intervention_Pharmacological
eprosartan
18472
Intervention_Pharmacological
eprosartan
18473
Intervention_Pharmacological
eprosartan
18474
Intervention_Pharmacological
enalapril
18475
Intervention_Pharmacological
eprosartan and enalapril
18476
Intervention_Pharmacological
Eprosartan
18477
Intervention_Pharmacological
eprosartin
18478
Intervention_Pharmacological
enalapril
18479
Intervention_Pharmacological
eprosartan or enalapril
18480
Outcome_Physical
blood pressure
18481
Outcome_Physical
platelets
18482
Outcome_Physical
endothelium function
18483
Outcome_Physical
platelet and endothelial function
18484
Outcome_Physical
platelet factor 4 ( PF-4 ) , beta-thromboglobulin ( beta-TG )
18485
Outcome_Physical
the ratio of platelet factor 4 to beta-thromboglobulin
18486
Outcome_Physical
endothelial function by measuring total plasma nitrate levels
18487
Outcome_Physical
von Willebrand factor ( vWF ) levels
18488
Outcome_Physical
blood flow using venous occlusive plethysmography
18489
Outcome_Physical
sitting blood pressure
18490
Outcome_Physical
diastolic blood pressure ( DPB )
18491
Outcome_Physical
DBP
18492
Outcome_Physical
platelet activation
18493
Outcome_Physical
endothelial dysfunction
18494
Outcome_Physical
blood pressure
18495
Outcome_Other
effective
18496
Outcome_Other
well-tolerated
18497
Outcome_Physical
DBP
18498
Outcome_Physical
platelet activation
18499
Participant_Condition
essential hypertension
18500
Participant_Sample-size
42
18501
Participant_Sample-size
27
18502
Participant_Sex
males
18503
Participant_Sample-size
15
18504
Participant_Sex
females
18505
Participant_Condition
hypertensive