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Blood pressure and plasma renin activity responses to different strategies to inhibit the renin-angiotensin-aldosterone system during exercise
- Source :
- Journal of the Renin-Angiotensin-Aldosterone System, Vol 14 (2013)
- Publication Year :
- 2013
- Publisher :
- Hindawi - SAGE Publishing, 2013.
-
Abstract
- Objective: The effect of two different strategies for renin–angiotensin–aldosterone system (RAAS) blockade; direct renin inhibition (DRI) versus angiotensin receptor blockade (ARB) on blood pressure (BP) and plasma renin activity (PRA) was compared during exercise. Methods: Hypertensive adults were randomised to aliskiren (300 mg once daily, n =33) or valsartan (320 mg once daily, n =35). BP and PRA were measured during treadmill exercise (Bruce protocol), at baseline, end of treatment (eight weeks), and after treatment withdrawal (48 hours after last dose). Results: After eight weeks treatment, Aliskiren inhibited PRA (>80%) at rest and during exercise, with inhibition remaining undiminished 48 hours after treatment withdrawal. In contrast, valsartan increased PRA at rest, and more-so during exercise (>400%). Angiotensin receptor blockade, as indicated by PRA increase, was reduced, 48 hours after valsartan treatment withdrawal, suggesting more sustained RAAS blockade with aliskiren. Despite divergent effects on PRA, similar exercise-induced changes in BP were seen. The primary outcome, the rise in systolic BP from rest to peak exercise (baseline to after treatment withdrawal) did not differ between treatments ( p =0.25). Conclusion: Measurement of PRA is a more sensitive index of RAAS blockade than the BP response during exercise. Furthermore, after treatment withdrawal, aliskiren provides more sustained RAAS inhibition than valsartan at rest and during exercise.
- Subjects :
- Adult
Male
medicine.medical_specialty
Angiotensin receptor
Medicine (General)
Endpoint Determination
Systole
Tetrazoles
Blood Pressure
Pharmacology
Arginine
Plasma renin activity
Renin-Angiotensin System
chemistry.chemical_compound
Endocrinology
R5-920
Fumarates
Internal medicine
Natriuretic Peptide, Brain
Renin
Renin–angiotensin system
Internal Medicine
medicine
Humans
Exercise physiology
Exercise
Aged
Demography
business.industry
Valine
Middle Aged
Aliskiren
Amides
Blockade
Blood pressure
Valsartan
chemistry
Female
business
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 17528976 and 14703203
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Journal of the Renin-Angiotensin-Aldosterone System
- Accession number :
- edsair.doi.dedup.....c27283c21b433e98eb79bd4c891ac332