title: Effects of olmesartan on blood pressure and insulin resistance in hypertensive patients with sleep-disordered breathing.
abstract: The increased risk of cardiovascular morbidity and mortality among patients with sleep-disordered breathing (SDB) has been linked to arterial hypertension and insulin resistance. However, an effective antihypertensive agent for patients with SDB has not been identified. We investigated the effect of the angiotensin II subtype 1 receptor blocker olmesartan in hypertensive patients with SDB. This prospective, one-arm pilot study included 25 male patients with untreated SDB (mean age, 52.7 ± 11.4 years). We measured blood pressure, oxygen desaturation index (ODI), cardiac function using echocardiography, and insulin resistance using the homeostasis model assessment (HOMA) before and after 12 weeks of olmesartan therapy (mean dose, 17.6 ± 4.4 mg/day). Olmesartan significantly decreased systolic blood pressure (151.4 ± 8.0 vs. 134.0 ± 7.4 mmHg; P < 0.001), diastolic blood pressure (93.4 ± 7.1 vs. 83.9 ± 6.3 mmHg; P < 0.001), and HOMA index (3.7 ± 2.9 vs. 2.8 ± 1.9; P = 0.012). Furthermore, left ventricular ejection fraction significantly increased at 12 weeks (68.1 ± 5.1 vs. 71.6 ± 5.4%; P = 0.009). However, body mass index (BMI) and degree of SDB did not change (BMI, 26.6 ± 4.0 vs. 26.6 ± 4.2 kg/m2, P = 0.129; 3% ODI, 29.5 ± 23.1 vs. 28.2 ± 21.0 events/h, P = 0.394). Olmesartan significantly reduced blood pressure and insulin resistance in hypertensive patients with SDB without changing BMI or SDB severity.
authors.affiliation: Cardiovascular Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan. tomotakadohi@msh.biglobe.ne.jp
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Koji
authors.initials: K
authors.lastname: Narui
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Hisashi
authors.initials: H
authors.lastname: Takaya
authors.forename: Ayako
authors.initials: A
authors.lastname: Inoshita
authors.forename: Kenichi
authors.initials: K
authors.lastname: Maeno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kasagi
authors.forename: Sugao
authors.initials: S
authors.lastname: Ishiwata
authors.forename: Minoru
authors.initials: M
authors.lastname: Ohno
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D007093:Imidazoles / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007564:Japan; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000503:physiopathology; D013318:Stroke Volume / Q000187:drug effects; D013777:Tetrazoles / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001786:Blood Glucose; D007093:Imidazoles; D007328:Insulin; D013777:Tetrazoles; C437965:olmesartan