title: Effects of angiotensin II type 1 receptor blocker on blood pressure variability and cardiovascular remodeling in hypertensive patients on chronic peritoneal dialysis.
abstract: OBJECTIVE
  In this study, we examined whether addition of an angiotensin II type 1 receptor blocker (ARB), candesartan or valsartan, to conventional antihypertensive treatment could improve blood pressure (BP) variability in hypertensive patients on peritoneal dialysis.
  
  
  METHODS
  45 hypertensive patients on chronic peritoneal dialysis therapy were randomly assigned to the ARB treatment groups either by candesartan (n = 15) or valsartan (n = 15), or the control group (n = 15). At baseline and 6 months after the treatment, 24-hour ambulatory BP monitoring, echocardiography, and measurement of brachial-ankle pulse wave velocity (baPWV) were performed.
  
  
  RESULTS
  After the 6 months of treatment, 24-hour ambulatory BP values were similarly decreased in both the control group and ARB groups. However, short-term BP variability assessed on the basis of the standard deviation of 24-hour ambulatory BP was significantly decreased in the ARB groups, but remained unchanged in the control group. Furthermore, parameters of cardiovascular remodeling assessed by natriuretic peptides, echocardiography, and baPWV were significantly improved in the ARB groups but not in the control group.
  
  
  CONCLUSIONS
  ARB treatment and control antihypertensive treatment similarly controlled 24-hour ambulatory BP values in hypertensive patients on peritoneal dialysis. However, ARB treatment is beneficial for the suppression of pathological cardiovascular remodeling with a decrease in BP variability.
authors.affiliation: Department of Cardiorenal Medicine, Yokohama City University School of Medicine, Yokohama, Japan.
authors.forename: Atsu-ichiro
authors.initials: A
authors.lastname: Shigenaga
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tamura
authors.forename: Toru
authors.initials: T
authors.lastname: Dejima
authors.forename: Motoko
authors.initials: M
authors.lastname: Ozawa
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Wakui
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Masuda
authors.forename: Koichi
authors.initials: K
authors.lastname: Azuma
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tsurumi-Ikeya
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitsuhashi
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Okano
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Kokuho
authors.forename: Teruyasu
authors.initials: T
authors.lastname: Sugano
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Ishigami
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Toya
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Uchino
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tokita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura