Does long-term losartan- vs atenolol-based antihypertensive treatment influence collagen markers differently in hypertensive patients? A LIFE substudy.
BACKGROUND
The aim of this study was to investigate the effects of losartan- vs atenolol-based antihypertensive treatment on circulating collagen markers beyond the initial blood pressure (BP) reduction.


METHODS
In 204 patients with hypertension and left ventricular (LV) hypertrophy we measured serum concentration of carboxy-terminal telopeptide of type I procollagen (ICTP), carboxy-terminal propeptide of type I procollagen (PICP), amino-terminal propeptide of type III procollagen (PIIINP), amino-terminal propeptide of type I procollagen (PINP) and LV mass by echocardiography at baseline and annually during 4 years of losartan- or atenolol-based antihypertensive treatment; 185 patients completed the study.


RESULTS
Beyond the first year of treatment systolic and diastolic BP, LV mass index (LVMI) as well as collagen markers did not change significantly and were equal in the two treatment groups. Changes in PICP during first year of treatment were related to subsequent changes in LV mass index after 2 and 3 years of treatment (r=0.28 and r=0.29, both p<0.05) in patients randomized to losartan, but not atenolol.


CONCLUSIONS
Long-term losartan- vs atenolol-based antihypertensive treatment did not influence collagen markers differently, making a BP-independent effect of losartan on collagen markers unlikely. However, initial reduction in circulating PICP may predict later regression of LV hypertrophy during losartan-based antihypertensive treatment.
Christensen
Marina K
MK
Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, University of Copenhagen, Denmark. marina@dadlnet.dk
Olsen
Michael H
MH
Wachtell
Kristian
K
Tuxen
Christian
C
Fossum
Eigil
E
Bang
Lia E
LE
Wiinberg
Niels
N
Devereux
Richard B
RB
Kjeldsen
Sverre E
SE
Hildebrandt
Per
P
Rokkedal
Jens
J
Ibsen
Hans
H
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology*; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology*; D001262:Atenolol / Q000494:pharmacology*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005355:Fibrosis / Q000188:drug therapy; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D019808:Losartan / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D011347:Procollagen / Q000097:blood* / Q000737:chemistry
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D015415:Biomarkers; D011347:Procollagen; D001262:Atenolol; D019808:Losartan