title: Valsartan and retinal endothelial function in elderly hypertensive patients.
abstract: BACKGROUND
  The aim of this study was to investigate the impact of short-term treatment with the angiotensin II receptor blocker (ARB) valsartan on retinal endothelial function in elderly patients with mild to moderate essential hypertension.
  
  
  METHODS
  In an open-labeled study, 20 elderly, male patients with arterial hypertension (WHO I-II) were treated with the ARB valsartan (80-160 mg once daily) over 8 days. Central retinal artery perfusion at rest and during flicker light stimulation was measured before and after treatment using pulsed wave Doppler sonography. Retinal capillary flow was assessed with scanning laser Doppler flowmetry at rest and following systemic infusion of the nitric oxide synthase (NOS) inhibitor NG-monomethyl-L-arginine (L-NMMA).
  
  
  RESULTS
  While valsartan significantly lowered blood pressure, central retinal artery perfusion at rest as well as after flicker light stimulation was similar before and after treatment. Similarly, retinal capillary flow at rest and after infusion of L-NMMA did not change with valsartan after 7 days of treatment. Subgroup analysis revealed that changes in retinal capillary flow in response to L-NMMA might be dependent on serum low-density lipoprotein (LDL) cholesterol levels of study participants. After treatment with valsartan, retinal capillary flow in response to L-NMMA decreased more in patients with low (< 3.54 mmol/l) than with high LDL-cholesterol levels (-12.6 +/- 20.2% vs 12.3 +/- 19.5%, p < 0.05).
  
  
  CONCLUSIONS
  Short-term treatment with valsartan did not improve retinal endothelial function in elderly hypertensive patients.
authors.affiliation: Department of Nephrology and Hypertension, University of Erlangen-Nürnberg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Oehmer
authors.forename: Joanna
authors.initials: J
authors.lastname: Harazny
authors.forename: Christian
authors.initials: C
authors.lastname: Delles
authors.forename: Thomas
authors.initials: T
authors.lastname: Schwarz
authors.forename: Renate
authors.initials: R
authors.lastname: Handrock
authors.forename: Georg
authors.initials: G
authors.lastname: Michelson
authors.forename: Roland E
authors.initials: RE
authors.lastname: Schmieder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012161:Retinal Artery / Q000473:pathology / Q000503:physiopathology; D013777:Tetrazoles / Q000008:administration & dosage / Q000494:pharmacology*; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000494:pharmacology; D000068756:Valsartan; D019323:omega-N-Methylarginine / Q000494:pharmacology
chemical_list: D008078:Cholesterol, LDL; D013777:Tetrazoles; D019323:omega-N-Methylarginine; D000068756:Valsartan; D014633:Valine