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Treatment with the angiotensin II receptor blocker telmisartan delivered greater beneficial effects on biomarkers than non-ARB therapy in hypertensive patients, according to the ATTEMPT-CVD study yesterday. The Japanese study, also published in the European Journal of Preventive Cardiology, showed that telmisartan promoted both smaller increases in plasma brain natriuretic peptide (BNP) and larger decreases in urinary albumin creatinine ratio (UACR).
While it is known that ARBs affect levels of biomarkers such as urinary albumin and BNP, studies measuring biomarkers in hypertensive patients and relating them to cardiovascular events have been rare. In this study Hisao Ogawa and colleagues from Kumamoto University, Japan, investigated the effect of an ARB and non-ARB on biomarker change and the incidence of cardiovascular events in hypertensive patients.
A total of 1228 hypertensive patients aged 40-80 years with at least one other cardiovascular risk factor (diabetes, renal, cerebral or peripheral artery factors) were randomly assigned to receive telmisartan (n = 615) or non-ARB standard treatment (n = 613). Patients were enrolled from 168 institutions throughout Japan.
Results showed that in comparison to baseline UACR changes in the ARB group were significantly steeper than in the non-ARB group (P<0.0010). The increase of plasma BNP over time in the ARB arm was significantly less than for the non-ARB arm. While fewer cardiovascular events occurred among patients in the ARB group, the difference was not statistically significant.
‘Taken together with the finding that there were no significant differences in blood pressure between the ARB and non-ARB groups throughout the treatment, this study provides the first evidence that ARB treatment suppressed an age-associated increase in plasma BNP independently of blood pressure,’ said the authors.
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