Single-dose effects of isosorbide mononitrate alone or in combination with losartan on central blood pressure

Rhonda Kaufman, Irene Nunes, James A. Bolognese, Deborah L. Miller, Dennis Salotti, Jennifer M. McCarthy, William B. Smith, Gary A. Herman, Peter U. Feig

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Antihypertensive drugs can have different effects on central and brachial blood pressures, which may affect outcomes. Nitric oxide donors have acute effects on central blood pressure but have not been assessed with renin-angiotensin system blockade. Thirteen patients with prehypertensive/Stage 1 hypertension were randomized to five single-dose treatments separated by ≤4 days using a double-blind, crossover study design: angiotensin receptor blocker (ARB) losartan 100 mg, isosorbide mononitrate (ISMN) 60 mg, losartan 100 mg + ISMN 15 mg, losartan 100 mg + ISMN 60 mg, and placebo. Central and brachial blood pressures were measured throughout 10 hours. Mean placebo-subtracted decrease from baseline in augmentation index (AIx) approximately 1% for losartan 100 mg, 26% for ISMN 60 mg, 19% for losartan 100 mg + ISMN 15 mg, and 24% for losartan 100 mg + ISMN 60 mg. Administered with losartan 100 mg or alone, ISMN lowered AIx, demonstrating that acute effects of a nitrate donor are much larger than those of an ARB even when administered with an ARB. Differences from placebo were statistically significant except for losartan 100 mg. AIx is a good biomarker of acute hemodynamic effects of nitric oxide in prehypertensive/Stage 1 hypertension.

Original languageEnglish (US)
Pages (from-to)311-318
Number of pages8
JournalJournal of the American Society of Hypertension
Volume4
Issue number6
DOIs
StatePublished - Nov 1 2010

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isosorbide-5-mononitrate
Losartan
Blood Pressure
Angiotensin Receptor Antagonists
Placebos
Cross-Over Studies
Arm
Hypertension
Nitric Oxide Donors
Renin-Angiotensin System
Double-Blind Method
Nitrates
Antihypertensive Agents

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Single-dose effects of isosorbide mononitrate alone or in combination with losartan on central blood pressure. / Kaufman, Rhonda; Nunes, Irene; Bolognese, James A.; Miller, Deborah L.; Salotti, Dennis; McCarthy, Jennifer M.; Smith, William B.; Herman, Gary A.; Feig, Peter U.

In: Journal of the American Society of Hypertension, Vol. 4, No. 6, 01.11.2010, p. 311-318.

Research output: Contribution to journalArticle

Kaufman, Rhonda ; Nunes, Irene ; Bolognese, James A. ; Miller, Deborah L. ; Salotti, Dennis ; McCarthy, Jennifer M. ; Smith, William B. ; Herman, Gary A. ; Feig, Peter U. / Single-dose effects of isosorbide mononitrate alone or in combination with losartan on central blood pressure. In: Journal of the American Society of Hypertension. 2010 ; Vol. 4, No. 6. pp. 311-318.
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