We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Low-Grade Inflammation and Ambulatory Blood Pressure Response to Antihypertensive Treatment: The ALPHABET Study.
- Authors
Fukutomi, Motoki; Hoshide, Satoshi; Eguchi, Kazuo; Watanabe, Tomonori; Kario, Kazuomi
- Abstract
BACKGROUND We examined whether the level of highsensitivity C-reactive protein (hsCRP), a marker of low-grade inflammation, predicted the response of clinic and ambulatory blood pressure (BP) to antihypertensive treatment. METHODS A randomized, open-label, multicenter trial was performed in 88 hypertensive patients (mean age = 63.4 years) allocated to receive losartan 50 mg or amlodipine 5 mg for 4 weeks, and each treatment was changed to losartan 50 mg/hydrochlorothiazide (HCTZ) 12.5 mg in combination or amlodipine 10 mg for a further 4 weeks. Clinic and ambulatory BP were measured before and after 8 weeks of treatment, and hsCRP was measured at baseline. RESULTS The patients were divided into groups with hsCRP levels above and below the median (0.47 mg/L) for the study population. In the total population, 24-hour systolic BP (SBP) (P = 0.03) and daytime SBP (P = 0.01) were significantly higher in the above-median hsCRP group after 8 weeks of treatment. In multivariable regression analysis, baseline hsCRP was a significant determinant of the percentage change in daytime SBP (β = 0.29; P = 0.02) in the total population. In the losartan/HCTZ treatment group, changes in 24-hour SBP, daytime SBP, and diastolic BP were significantly smaller in the above-median hsCRP group than the below-median hsCRP group, whereas the amlodipine group did not show these differences. CONCLUSIONS Baseline low-grade inflammation in patients with hypertension was associated with a poor ambulatory BP response, especially with losartan/HCTZ treatment. Initial measurement of hsCRP could be useful for selection of an appropriate antihypertensive drug. CLINICAL TRIALS REGISTRATION Trial Number UMIN000002438
- Subjects
INFLAMMATION; BLOOD pressure; C-reactive protein; LOSARTAN; HYDROCHLOROTHIAZIDE
- Publication
American Journal of Hypertension, 2013, Vol 26, Issue 6, p784
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpt024