| Title |
Adding thiazide to a rennin-angiotensin blocker regimen to improve left ventricular relaxation in diabetes and nondiabetes patients with hypertension
|
|---|---|
| Published in |
Drug Design, Development and Therapy, September 2012
|
| DOI | 10.2147/dddt.s35738 |
| Pubmed ID | |
| Authors |
Takeshi Takami, Hiroshi Ito, Katsuhisa Ishii, Kenei Shimada, Katsuomi Iwakura, Hiroyuki Watanabe, Shota Fukuda, Junichi Yoshikawa |
| Abstract |
The urinary albumin to creatinine ratio (UACR) is an independent predictor of outcomes in patients with diastolic dysfunction. Thus, we investigated the relationship between diastolic dysfunction, UACR, and diabetes mellitus (DM) in the EDEN study. We investigated the effect of switching from an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) to a combination of losartan and hydrochlorothiazide on left ventricular (LV) relaxation in patients with hypertension and diastolic dysfunction. We enrolled 106 patients with and 265 patients without DM. All patients had diastolic dysfunction and had not achieved their treatment goals with an ACEi or ARB. The measurements of e' velocity and E/e' ratio was performed with echocardiography as markers of LV diastolic function. We switched the ACEi or ARB to losartan/hydrochlorothiazide and followed these patients for 24 weeks. UACR was decreased in patients with DM (123.4 ± 288.4 to 66.5 ± 169.2 mg/g creatinine; P = 0.0024), but not in patients without DM (51.2 ± 181.8 to 39.2 ± 247.9 mg/g creatinine; P = 0.1051). Among DM patients, there was a significant relationship between changes in UACR and changes in e' velocity (r = -0.144; P = 0.0257) and between changes in estimated glomerular filtration rate and changes in the E/e' ratio (r = -0.130; P = 0.0436). Among patients without DM, there was a significant relationship between changes in high-sensitivity C-reactive protein (hs-CRP) and changes in E/e' (r = 0.205; P = 0.0010). Multivariate analysis demonstrated changes in hemoglobin A(1c) levels as one of the determinants of change of e' and E/e' in patients with DM, whereas hs-CRP was the determinant of change of e' among patients without DM. These data suggest that improvement in LV diastolic function is associated with an improvement of DM and a concomitant reduction in UACR among DM patients, and with a reduction of hs-CRP in patients without DM when thiazide is added to a renin-angiotensin blocker treatment regimen. |
Mendeley readers
The data shown below were compiled from readership statistics for 19 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mexico | 1 | 5% |
| United States | 1 | 5% |
| Unknown | 17 | 89% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 3 | 16% |
| Student > Doctoral Student | 2 | 11% |
| Other | 2 | 11% |
| Student > Master | 2 | 11% |
| Student > Ph. D. Student | 2 | 11% |
| Other | 3 | 16% |
| Unknown | 5 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 9 | 47% |
| Environmental Science | 1 | 5% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 5% |
| Nursing and Health Professions | 1 | 5% |
| Biochemistry, Genetics and Molecular Biology | 1 | 5% |
| Other | 2 | 11% |
| Unknown | 4 | 21% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 September 2012.
All research outputs
#22,778,604
of 25,394,764 outputs
Outputs from Drug Design, Development and Therapy
#1,757
of 2,270 outputs
Outputs of similar age
#169,827
of 188,253 outputs
Outputs of similar age from Drug Design, Development and Therapy
#6
of 7 outputs
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