Olmesartan, an angiotensin II receptor blocker, restores cerebral hypoperfusion in elderly patients with hypertension.
We evaluated the effects of olmesartan, an angiotensin II receptor blocker (ARB), on cerebral blood flow (CBF) in elderly and hypertensive subjects. Ten subjects with first- or second-degree essential hypertension (mean age, 70.5 years) underwent brain single-photon emission tomography (SPECT) scanning with (99m)Tc-ethyl cysteinate dimer before and after a 24-week course of olmesartan. Mean systolic blood pressure (SBP) was 156.2+/-9.9 mm Hg, and mean diastolic blood pressure (DBP) was 89.1+/-5.5mm Hg. No subject had any abnormalities on neurologic examination or previous history of stroke or cardiovascular disease. Before olmesartan administration, the hypertensive subjects had approximately 15% less whole brain CBF compared with age-matched normotensive controls. Regional CBF was decreased by 11%-20% in the frontal, parietal, temporal, and posterior lobes. Olmesartan treatment significantly decreased SBP to 130.4+/-4.2mm Hg (P < .001) and DBP to 78.2+/-7.0mm Hg (P < .001). After 24 weeks of olmesartan treatment, CBF of whole brain and regional CBF of the frontal, parietal, and temporal lobe were similar to those of control subjects. Our brain SPECT data indicate that olmesartan restores brain hypoperfusion in elderly and hypertensive patients without organic damage. This ARB may have a favorable potential for cerebrovascular circulation, in addition to a blood pressure-lowering effect.
Nagata
Riya
R
Department of Neurology, Toho University Omori Medical Center, Tokyo 143-8541, Japan.
Kawabe
Kiyokazu
K
Department of Neurology, Toho University Omori Medical Center, Tokyo 143-8541, Japan.
Ikeda
Ken
K
Department of Neurology, Toho University Omori Medical Center, Tokyo 143-8541, Japan. Electronic address: keni@med.toho-u.ac.jp.
D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000187:drug effects*; D003545:Cysteine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D015609:Organotechnetium Compounds / Q000627:therapeutic use; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D015899:Tomography, Emission-Computed, Single-Photon
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D007093:Imidazoles; D015609:Organotechnetium Compounds; D013777:Tetrazoles; C437965:olmesartan; C059659:technetium Tc 99m bicisate; D003545:Cysteine