Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan.
Clin Exp Hypertens. 2012;34(1):17-23. doi: 10.3109/10641963.2011.628726. Epub 2011 Dec 9.
Advanced glycation end products (AGEs) are associated with comorbidity and death among patients on hemodialysis (HD). Angiotensin II type 1 receptor blockers (ARBs) can decrease the formation of AGEs in vitro. This study examines the ability of various ARBs to decrease plasma AGE levels in hypertensive patients on HD.
This preliminary randomized prospective study included 24 hypertensive patients on HD who were treated with candesartan (8 mg/day). The patients were randomly assigned to an olmesartan (20 mg/day, n = 12) or a telmisartan (40 mg/day, n = 12) group and followed up 24 weeks. Blood pressure was monitored before each HD session, and plasma pentosidine, N-(epsilon)-carboxymethyl-lysine (CML), serum malondialdehyde-low-density lipoprotein (LDL), high-sensitive CRP, and serum total free radical (TFR) were measured at baseline, and at 4, 12, and 24 weeks.
Olmesartan was significantly associated with decreased systolic blood pressure compared with telmisartan. After 24 weeks of treatment, plasma pentosidine and CML levels were significantly decreased and serum TFR levels tended to be decreased in the olmesartan group, but remained unchanged in the telmisartan group.
These results suggest that olmesartan can help to decrease plasma AGE levels in patients on HD.
晚期糖基化终产物（AGEs）与血液透析（HD）患者的合并症和死亡有关。血管紧张素 II 型 1 型受体阻滞剂（ARB）可减少体外 AGE 的形成。本研究探讨了各种 ARB 降低 HD 高血压患者血浆 AGE 水平的能力。
本初步随机前瞻性研究纳入了 24 名接受坎地沙坦（8mg/天）治疗的 HD 高血压患者。患者随机分为奥美沙坦（20mg/天，n=12）或替米沙坦（40mg/天，n=12）组，随访 24 周。在每次 HD 治疗前监测血压，并在基线、4、12 和 24 周时测量血浆戊糖、N-（ε）-羧甲基赖氨酸（CML）、血清丙二醛-低密度脂蛋白（LDL）、高敏 CRP 和血清总自由基（TFR）。
与替米沙坦相比，奥美沙坦与收缩压降低显著相关。治疗 24 周后，奥美沙坦组血浆戊糖和 CML 水平显著降低，血清 TFR 水平趋于降低，但替米沙坦组无变化。
这些结果表明，奥美沙坦可帮助降低 HD 患者的血浆 AGE 水平。
