Effect of the angiotensin II receptor blocker candesartan on fibrinolysis in patients with mild hypertension.
OBJECTIVE
Impaired fibrinolysis is frequently observed in patients with the metabolic syndrome. Aim of the study was to examine the short-term effect of angiotensin II receptor blockade on the fibrinolytic system.


METHODS
Seventy-four patients with mild hypertension were randomly assigned to a 7-day treatment period with either 16 mg candesartan cilexetil or placebo. Several variables of the fibrinolytic system such as plasminogen activator inhibitor-1 (PAI-1) antigen and activity, tissue plasminogen activator (t-PA) antigen and activity as well as circulating t-PA/PAI-1 complexes were determined.


RESULTS
At baseline, the body mass index but not blood pressure was positively associated with PAI-1 antigen (r=0.314, p<0.01) and PAI-1 activity (r=0.425, p<0.01) but negatively with t-PA activity (r=-0.187, p < 0.05). A 7-day treatment with 16 mg candesartan cilexetil resulted in a significant greater reduction of diastolic blood pressure (-10.3 +/- 10.8 mmHg vs.-5.8 +/- 8.5 mmHg, p=0.03). However, there was no significant effect of candesartan on all parameters of the fibrinolytic system under investigation, i.e. circulating PAI-1 antigen, PAI-1 activity, t-PA antigen, t-PA activity and t-PA/PAI-1 complexes. Furthermore, candesartan did not affect the characteristic circadian pattern of the variables of the fibrinolytic system.


CONCLUSIONS
We conclude that short-term blockade of the angiotensin II receptor subtype 1 with candesartan does not have an impact on fibrinolysis in patients with mild hypertension.
Skurk
T
T
German Diabetes Research Institute at the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Lee
Y-M
YM
Nicuta-Rölfs
T-O
TO
Haastert
B
B
Wirth
A
A
Hauner
H
H
D000328:Adult; D057911:Angiotensin Receptor Antagonists; D000886:Anthropometry; D000959:Antihypertensive Agents / Q000494:pharmacology*; D001562:Benzimidazoles / Q000494:pharmacology*; D001713:Biphenyl Compounds / Q000494:pharmacology*; D002940:Circadian Rhythm / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D013777:Tetrazoles; D010959:Tissue Plasminogen Activator / Q000097:blood
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D017395:Plasminogen Activator Inhibitor 1; D013777:Tetrazoles; D010959:Tissue Plasminogen Activator; C077793:candesartan cilexetil