PS 14-44 FEASIBILITY OF REGRESSION OF HYPERTENSION USING CONTEMPORARY ANTIHYPERTENSIVE MEDICATIONS. (September 2016)

• Record Type: Journal Article
• Authors: Nakaya, Hideaki; Sasamura, Hiroyuki; Julius, Stevo; Tomotsugu, Naoki; Sato, Yuji; Takahashi, Fumiaki; Takeuchi, Masahiro; Murakami, Marohito; Ryuzaki, Munekazu; Itoh, Hiroshi
• Is Part Of: Journal of hypertension. Volume 34:(2016) Supplement 1
• Publication Date: 2016-09
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000501166.79786.8f
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: We have reported that transient treatment of genetically hypertensive rats with high-dose angiotensin receptor blocker (ARB) causes regression of established hypertension. In this study, we investigated whether treatment with candesartan or nifedipine controlled-release(CR) resulted in a sustained regression of hypertension in human. Design and Method: Patients aged 30 to 59 years with untreated stage 1 essential hypertension and family history of hypertension were treated with the antihypertensive agents candesartan or nifedipineCR. After 1 year of treatment phase (phase 1), the medications were tapered and discontinued (phase 2). During phase 2, home and office blood pressures were monitored for another year to assess posttreatment reoccurrence of stage 1 hypertension. Results: In phase 1, after 1 year of treatment, a similary substantial blood pressure decrease was seen in the candesartan and nifedipine groups. In phase 2, there was a substantial reoccurrence of hypertension and at the study end, only one patient in the candesartan group was able to continue without antihypertensive medication. A Kaplan Meier analysis revealed a significant delay of reoccurrence of hypertension in the candesartan group. Conclusions: One year of treatment with candesartan or nifedipine CR was not associated with marked regression of hypertension in humans at the standard dose used in this trial. However, withdrawal of candesartan was associated with a slightly longer delay before restarting medications. Further studies with larger doses of candesartan given over a longer time are required to determine whether such a regimen may induce sustainable and clinically relevant reversal of hypertension and alteration in its natural history.