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losartan sleep

Barbara J Morgan, Mihaela Teodorescu, David F Pegelow, Emily R Jackson, Devin L Schneider, David T Plante, James P Gapinski, Scott J Hetzel, John M Dopp
Chemoreflex sensitization produced by chronic intermittent hypoxia (CIH) in rats is attenuated by angiotensin II type 1 receptor (AT1 R) blockade. AT1 R blockade and xanthine oxidase inhibition both ameliorate CIH-induced endothelial dysfunction. We hypothesized treatment with losartan and allopurinol would reduce chemoreflex sensitivity and improve hypoxic vasodilation in patients with obstructive sleep apnoea (OSA). Eighty-six hypertensive patients with apnoea-hypopnoea index ≥25 events/hr and no other cardiovascular, pulmonary, renal, or metabolic disease were randomly assigned to receive allopurinol, losartan, or placebo for 6 weeks...
May 11, 2018: Experimental Physiology
Rami N Khayat, Saradhadevi Varadharaj, Kyle Porter, Angela Sow, David Jarjoura, Mikhail A Gavrilin, Jay L Zweier
BACKGROUND: Obstructive sleep apnea (OSA) is associated with vascular endothelial dysfunction (VED) in otherwise healthy patients. The role of renin-angiotensin system (RAS) in the OSA induced VED is not well understood. METHODS: Recently diagnosed OSA patients with very low cardiovascular disease (CVD) risk (Framingham score <5%) were studied at diagnosis and after 12 weeks of verified continuous positive airway pressure (CPAP) therapy. Participants underwent biopsy of gluteal subcutaneous tissue at baseline and after CPAP...
February 9, 2018: American Journal of Hypertension
Raimundo Jenner, Fernanda Fatureto-Borges, Valéria Costa-Hong, Heno F Lopes, Sandra H Teixeira, Elias Marum, Dante A M Giorgi, Fernanda M Consolim-Colombo, Luiz A Bortolotto, Geraldo Lorenzi-Filho, Eduardo M Krieger, Luciano F Drager
Whether sex influences the association of obstructive sleep apnea (OSA) with markers of cardiovascular risk in patients with hypertension is unknown. In this study, 95 hypertensive participants underwent carotid-femoral pulse wave velocity, 24-hour ambulatory blood pressure monitoring, echocardiogram, and polysomnography after a 30-day standardized treatment with hydrochlorothiazide plus enalapril or losartan. OSA was present in 52 patients. Compared with non-OSA patients, pulse wave velocity values were higher in the OSA group (men: 11...
April 21, 2017: Journal of Clinical Hypertension
Mark Moran
Obstructive sleep apnea (OSA) is characterized by repeated involuntary closure of the pharyngeal airspace during sleep. Normal activity of the genioglossus (GG) muscle is important in maintaining airway patency, and inhibition of GG activity can contribute to airway closure. Neurons in the hypoglossal motor nucleus (HMN) regulate GG activity. Adrenergic tone is an important regulator of HMN neuronal excitability. In laboratory models α1-adrenergic antagonists inhibit HMN neurons and GG activity, suggesting that α1-adrenergic antagonism might adversely affect patients with OSA...
2016: Respiratory Medicine Case Reports
Erik Thunström, Karin Manhem, Tülay Yucel-Lindberg, Annika Rosengren, Caroline Lindberg, Yüksel Peker
RATIONALE: Blood pressure reduction in response to antihypertensive agents is less for patients with obstructive sleep apnea (OSA). Increased sympathetic and inflammatory activity, as well as alterations in the renin-angiotensin-aldosterone system, may play a role in this context. OBJECTIVES: To address the cardiovascular mechanisms involved in response to an angiotensin II receptor antagonist, losartan, and continuous positive airway pressure (CPAP) as add-on treatment for hypertension and OSA...
November 2016: Annals of the American Thoracic Society
Paramita Pati, David J R Fulton, Zsolt Bagi, Feng Chen, Yusi Wang, Julia Kitchens, Lisa A Cassis, David W Stepp, R Daniel Rudic
Blood pressure exhibits a robust circadian rhythm in health. In hypertension, sleep apnea, and even shift work, this balanced rhythm is perturbed via elevations in night-time blood pressure, inflicting silent damage to the vasculature and body organs. Herein, we examined the influence of circadian dysfunction during experimental hypertension in mice. Using radiotelemetry to measure ambulatory blood pressure and activity, the effects of angiotensin II administration were studied in wild-type (WT) and period isoform knockout (KO) mice (Per2-KO, Per2, 3-KO, and Per1, 2, 3-KO/Per triple KO [TKO] mice)...
March 2016: Hypertension
Weizhong Huangfu, Peilin Duan, Dingcheng Xiang, Ruiying Gao
The aim of this study was to explore the influence of combination therapy in different administration time on antihypertensive efficacy and blood pressure variability in patients with essential hypertension. A total of 86 patients with stage II to III essential hypertension were randomly divided into 4 groups: taking indapamide and losartan potassium together in the morning or in the evening 2 to 4 hours before sleep, indapamide in the morning and losartan potassium in the evening, losartan potassium in the morning and indapamide in the evening...
2015: International Journal of Clinical and Experimental Medicine
Márcio Galindo Kiuchi, Frederico Puppim Vitorio, Gustavo Ramalho da Silva, Luis Marcelo Rodrigues Paz, Gladyston Luiz Lima Souto
Premature ventricular complexes are very common, appearing most frequently in patients with hypertension, obesity, sleep apnea, and structural heart disease. Sympathetic hyperactivity plays a critical role in the development, maintenance, and aggravation of ventricular arrhythmias. Recently, Armaganijan et al reported the relevance of sympathetic activation in patients with ventricular arrhythmias and suggested a potential role for catheter-based renal sympathetic denervation in reducing the arrhythmic burden...
December 2015: Medicine (Baltimore)
Erik Thunström, Karin Manhem, Annika Rosengren, Yüksel Peker
RATIONALE: Obstructive sleep apnea (OSA) is common in people with hypertension, particularly resistant hypertension. Treatment with an antihypertensive agent alone is often insufficient to control hypertension in patients with OSA. OBJECTIVES: To determine whether continuous positive airway pressure (CPAP) added to treatment with an antihypertensive agent has an impact on blood pressure (BP) levels. METHODS: During the initial 6-week, two-center, open, prospective, case-control, parallel-design study (2:1; OSA/no-OSA), all patients began treatment with an angiotensin II receptor antagonist, losartan, 50 mg daily...
February 1, 2016: American Journal of Respiratory and Critical Care Medicine
Hyung-Min Kwon, Jung-Won Shin, Jae-Sung Lim, Yoon-Ho Hong, Yong-Seok Lee, Hyunwoo Nam
BACKGROUND: Lowering blood pressure (BP) and reducing diurnal variation are important for the prevention of stroke in patients with hypertension. OBJECTIVE: This study was conducted to compare the BP-lowering and diurnal BP variation effects of amlodipine and losartan on acute stroke patients. METHODS: Seventy-seven hypertensive patients with acute stroke were enrolled in this randomized, double-blind, single-center clinical trial. They were randomly assigned to receive either amlodipine or losartan daily...
December 2013: Clinical Therapeutics
Siu-Yin Lam, Yu Liu, Kwong-Man Ng, Emily C Liong, George L Tipoe, Po Sing Leung, Man-Lung Fung
The carotid body (CB) plays an important role in the alteration of cardiorespiratory activity in chronic intermittent hypoxia (IH) associated with sleep-disordered breathing, which may be mediated by local expression of the renin-angiotensin system (RAS). We hypothesized a pathogenic role for IH-induced RAS expression in the CB. The CB expression of RAS components was examined in rats exposed to IH resembling a severe sleep-apnoeic condition for 7 days. In situ hybridization showed an elevated expression of angiotensinogen in the CB glomus cells in the hypoxic group when compared with the normoxic control group...
January 2014: Experimental Physiology
Victor B Fenik, Tyana Singletary, Jennifer L Branconi, Richard O Davies, Leszek Kubin
BACKGROUND: Obstructive sleep apnea (OSA) is associated with glucose intolerance. Both chronic sleep disruption and recurrent blood oxygen desaturations (chronic-intermittent hypoxia, CIH) may cause, or exacerbate, metabolic derangements. METHODS: To assess the impact of CIH alone, without accompanying upper airway obstructions, on the counter-regulatory response to glucose load and cardiorespiratory parameters, we exposed adult male Sprague-Dawley rats to CIH or sham room air exchanges for 10 h/day for 7, 21, or 35 days and then, 1 day after conclusion of CIH exposure, conducted intravenous glucose-tolerance tests (ivgtt) under urethane anesthesia...
2012: Frontiers in Neurology
Aoi Kamura, Teruo Inoue, Shigetaka Kuroki, Shiro Ishida, Kenichirou Iimori, Toru Kato, Hirofumi Naitoh, Satoshi Tamesue, Hideo Ikeda, Koichi Node
The aim of the Saga Challenge Antihypertensive Study (S-CATS), a single-arm, prospective and multi-center trial, was to evaluate the effectiveness of combined antihypertensive treatment with losartan and hydrochlorothiazide (HCTZ). Enrolled in the study were a total of 161 patients with hypertension, who in spite of treatment with an angiotensin receptor blocker (ARB) alone or an ARB and calcium channel blocker (CCB), had not been able to reach blood pressure control goals set by the Japanese Society of Hypertension Guidelines (JSH 2004)...
December 2011: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Ana Quenia Gomes da Silva, Marco Antônio Peliky Fontes, Nancy Lapp Kanagy
Sleep apnea is characterized by increased sympathetic activity and is associated with systemic hypertension. Angiotensin (Ang) peptides have previously been shown to participate in the regulation of sympathetic tone and arterial pressure in the hypothalamic paraventricular nucleus (PVN) neurons. We investigated the role of endogenous Ang peptides within the PVN to control blood pressure in a rat model of sleep apnea-induced hypertension. Male Sprague-Dawley rats (250 g), instrumented with bilateral guide cannulae targeting the PVN, received chronic infusion of Ang antagonists (A-779, Ang-(1-7) antagonist; losartan and ZD7155, AT(1) antagonists; PD123319, AT(2) receptor antagonist, or saline vehicle)...
January 12, 2011: Brain Research
Glen E Foster, Patrick J Hanly, Sofia B Ahmed, Andrew E Beaudin, Vincent Pialoux, Marc J Poulin
Intermittent hypoxia (IH) is believed to contribute to the pathogenesis of hypertension in obstructive sleep apnea through mechanisms that include activation of the renin-angiotensin system. The objective of this study was to assess the role of the type I angiotensin II receptor in mediating an increase in arterial pressure associated with a single 6-hour IH exposure. Using a double-blind, placebo-controlled, randomized, crossover study design, we exposed 9 healthy male subjects to sham IH, IH with placebo medication, and IH with the type I angiotensin II receptor antagonist losartan...
September 2010: Hypertension
Fabíola C Nunes, Thaís P Ribeiro, Maria S França-Silva, Isac A Medeiros, Valdir A Braga
Peripheral chemoreflex activation has been considered the key drive for the overactivity of the sympathetic nervous system observed in some pathological conditions such as sleep obstructive apnea. In addition, increases in angiotensin-II-derived reactive oxygen species found in some autonomic regulatory brain areas have been implicated in hypertension. However, a link between oxidative stress and peripheral chemoreflex integration within the RVLM has never been investigated. Here, we tested the hypothesis that the pressor response induced by peripheral chemoreflex activation involves the angiotensin-II/AT(1)R/superoxide pathway within the rostral ventrolateral medulla (RVLM)...
September 10, 2010: Brain Research
Rosalba Cammarata, María José Armas-Hernández, Rafael Hernández-Hernández, María Cristina Armas-Padilla, Beatriz Sosa-Canache, Beatriz Pacheco, Jaime Guerrero, Zafar H Israili, Manuel Valasco
The objective of this study was to investigate the effects of losartan (100 mg) plus hydrochlorothiazide (HCTZ; 25 mg) on nitric oxide (NO) production and blood pressure (BP) in "nondipper" severe hypertensive patients. Twelve hypertensive "nondipper patients" (6 of each gender) with sitting systolic/diastolic BP of 188.0 +/- 5.2/116.2 +/- 1.2 mm Hg were studied by 24-hour ambulatory blood pressure monitoring (ABPM) after daily administration of 100 mg losartan plus 25 mg HCTZ for a period of 12 weeks. Office and mean 24-hour, as well as mean awake- and sleep-time systolic/diastolic BP, serum NO levels, and urinary excretion of NO were measured after the placebo period (3 weeks) and after 12 weeks of therapy...
March 2007: American Journal of Therapeutics
P A Zelveian, E V Oshchepkova, M S Buniatian, A N Rogoza
AIM: To estimate the efficacy of 8-week antihypertensive monotherapy in patients with arterial hypertension (AH) regarding the presence of obstructive sleep apnea syndrome (OSAS). MATERIAL AND METHODS: We analysed the results of 24-h blood pressure (BP) monitoring of 26 inpatients (mean age 54 +/- 2 years) with mild (n = 18) and moderate (n = 8) AH before and after 8 weeks of treatment with 5-10 mg amlodipine or 50-100 mg of losartan once daily to assess blood pressure profile parameters...
2004: Terapevticheskiĭ Arkhiv
Trefor Morgan
Angiotensin II and sodium balance affect the status of each other and both--either separately or together--can lead to an increase in blood pressure. They also can cause vascular and cardiac damage due to direct effects and effects mediated by the blood pressure increase. This paper reviews the important interactions among these three variables. Acute blood pressure elevation during sleeping but not during waking hours causes cardiac hypertrophy in rats. Similarly, lowering of blood pressure with an angiotension converting enzyme (ACE) inhibitor during sleep but not when awake causes regression of cardiac hypertrophy in rats with 2kidney (K)-1clip (C) Goldblatt hypertension...
May 2003: Hypertension Research: Official Journal of the Japanese Society of Hypertension
A Hrycek, R Badowski, J Scieszka, P Haczkiewicz, J Hefczyc, P Cieślik
This study was conducted in 19 patients with mild or moderate essential hypertension randomised open trial to evaluate the influence of potassium losartan dosed 50 mg per day on blood pressure, metabolic processes and left ventricular heart function. The following intervals of examination were accepted-at entry (before therapy with losartan) and then after 10 days; after 30 days and after 60 days of treatment. Mean values of arterial blood pressure and heart rate measured by conventional technics and obtained from 24-hour ambulatory monitoring data, biochemical results (serum levels of glucose, uric acid, creatinine, sodium, potassium, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, bilirubin and serum activity of aminotransferases) and selected indices of left ventricular heart function were evaluated as intragroup differences using Student's paired t test...
October 2001: Polskie Archiwum Medycyny Wewnętrznej
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