title: Effects of valsartan on fibrinolysis in hypertensive patients with metabolic syndrome.
abstract: BACKGROUND
  The purpose of this study was to analyze the effect of valsartan on abnormal adipocyte metabolism and prothrombotic state in hypertensive patients with metabolic syndrome (MetS).
  
  
  RESULTS
  We conducted a multicenter, prospective, randomized, parallel-group controlled trial in 150 hypertensive patients with MetS. They were randomly assigned to receive either 80-160 mg valsartan per day (valsartan group, n=79) or other conventional treatment without a renin-angiotensin system (RAS) inhibitor (non-RAS inhibitor group, n=71). After 1 year, there were no significant differences between the 2 groups in the changes in systolic and diastolic blood pressures (valsartan: 153±15/86±15 to 138±16/77±12 mmHg; non-RAS inhibitor: 150±14/82±15 to 137±15/76±10 mmHg). There was a significant difference in the change in the levels of plasminogen activator inhibitor-1 (PAI-1) between the 2 groups after 1 year (valsartan: 3.7±3.2 ng/ml; non-RAS inhibitor: 5.8±3.3 ng/ml, P=0.04). There was no significant difference between groups in the change in the concentration of adiponectin after 1 year (valsartan: 0.3±0.4 µg/ml; non-RAS inhibitor: 0.9±0.4 µg/ml, P=0.22). The animal study showed aortic PAI-1 protein expression was reduced in double knockout mice of angiotensin II type 1a receptor and apolipoprotein E (apoE) compared with the apoE knockout mice.
  
  
  CONCLUSIONS
  Valsartan reduced plasma PAI-1 levels compared to non-RAS inhibitor in hypertensive patients with MetS, which suggests it may be useful for improving fibrinolytic function.
authors.affiliation: Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyata
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Shuji
authors.initials: S
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Abe
authors.forename: Shinichi
authors.initials: S
authors.lastname: Minagoe
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Torii
authors.forename: Souki
authors.initials: S
authors.lastname: Lee
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tateishi
authors.forename: Koichi
authors.initials: K
authors.lastname: Kihara
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ohba
authors.forename: Shoko
authors.initials: S
authors.lastname: Kajiya
authors.forename: Yuko
authors.initials: Y
authors.lastname: Furusho
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hamasaki
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D017667:Adipocytes / Q000187:drug effects / Q000378:metabolism; D052242:Adiponectin / Q000097:blood; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001011:Aorta / Q000187:drug effects / Q000378:metabolism; D001057:Apolipoproteins E / Q000172:deficiency / Q000235:genetics; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D004195:Disease Models, Animal; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D007564:Japan; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications*; D051379:Mice; D018345:Mice, Knockout; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011446:Prospective Studies; D044140:Receptor, Angiotensin, Type 1 / Q000172:deficiency / Q000235:genetics; D013777:Tetrazoles / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; C544066:Agtr1a protein, mouse; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001057:Apolipoproteins E; D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D044140:Receptor, Angiotensin, Type 1; C051321:SERPINE1 protein, human; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine