New angiotensin II type 1 receptor blocker olmesartan improves portal hypertension in patients with cirrhosis.
OBJECTIVE
To evaluate the effect of the new oral angiotensin II type 1 receptor blocker olmesartan on portal hemodynamics in patients with cirrhosis.


METHODS
From January 2005 to March 2006, 18 cirrhosis patients treated with endoscopic band ligation for primary esophageal variceal bleeding were included in the present study. Hepatic venous pressure gradient (HVPG) of the patients was >/=12 mmHg at baseline measurement. The patients were given 10 mg olmesartan orally once daily for 2 weeks. Eighteen cirrhosis patients with esophageal variceal bleeding who did not receive any antihypertensive agents were included in the study as control. On day 14, HVPG, blood pressure, heart rate, and parameters of hepatic and renal function were examined after the treatment. Responders were defined as those with HVPG reduction of >20% versus baseline.


RESULTS
Olmesartan significantly reduced HVPG by -16.8 +/- 22.0% (P = 0.031) and mean arterial pressure by -13.1 +/- 10.8% (P = 0.0041). Six of 18 (33.3%) patients in the olmesartan group showed >20% reduction of HVPG from baseline values. None of the patients treated with olmesartan had any complications.


CONCLUSIONS
Olmesartan reduces portal pressure and may be safe and highly effective in the treatment of portal hypertension.
Hidaka
Hisashi
H
Gastroenterology Division of Internal Medicine, Kitasato University East Hospital, Sagamihara, Japan.
Kokubu
Shigehiro
S
Nakazawa
Takahide
T
Okuwaki
Yuusuke
Y
Ono
Kouji
K
Watanabe
Masaaki
M
Shibuya
Akitaka
A
Saigenji
Katsunori
K