Department of Nephrology, Sisli Etfal Research and Educational Hospital, Istanbul, Turkey.
Eur Rev Med Pharmacol Sci. 2011 Dec;15(12):1389-94.
We aimed to investigate whether Olmesartan had an effect on cystatin C levels in hypertensive patients, and evaluate its correlation with blood pressure (BP).
Seventy-two patients essential hypertension patients with a known for, at most, the last 3 years were enrolled to the study. Patients were divided in three groups (group 1; receives 20 mg/day olmesartan; group 2, receives 40 mg/day olmesartan; group 3, receives Olmesartan plus hydrochlorothiazide), according to their BP measurements. Blood samples (serum urea, creatinine, sodium, potassium and cystatin C) were collected initially and at the end of the study from all patients and the correlation of these parameters with BP and drug use was investigated.
There were no significantly difference between the groups in terms of age, gender, serum urea, creatinine, cystatin C and diastolic BP levels (p > 0.05); while, systolic BP was significantly higher in group 3 at baseline (p = 0.001). After 3 months of olmesartan treatment, the mean serum cystatin C (p: 0.001, 0.023 and 0.018 respectively), systolic (p: 0.001, 0.001 and 0.001 respectively) and diastolic BP levels (p: 0.001, 0.001 and 0.001 respectively) decreased in all groups. However, there was no significant difference in serum creatinine levels (p > 0.05). There were not found correlation between the changes of systolic and diastolic BP and cystatin C levels.
Cystatin C is a more sensitive marker to detect of early kidney dysfunction compared to serum creatinine level. Olmesartan treatment led to a decrease of cystatin C level. Therefore, olmesartan can be used to prevent the renal damage in patients with hypertensive and it is independent of drop in blood pressure.
本研究旨在探讨奥美沙坦对高血压患者胱抑素 C 水平的影响，并评估其与血压（BP）的相关性。
本研究纳入了 72 名确诊高血压且病史不超过 3 年的患者。根据血压测量结果，将患者分为三组（组 1：接受 20 mg/天奥美沙坦治疗；组 2：接受 40 mg/天奥美沙坦治疗；组 3：接受奥美沙坦加氢氯噻嗪治疗）。所有患者在研究开始和结束时均采集血样（血清尿素、肌酐、钠、钾和胱抑素 C），并探讨这些参数与 BP 和药物使用的相关性。
三组患者在年龄、性别、血清尿素、肌酐、胱抑素 C 和舒张压水平方面无显著差异（p>0.05）；而组 3 的收缩压在基线时明显较高（p=0.001）。经过 3 个月的奥美沙坦治疗，所有组的血清胱抑素 C 均值（p：0.001、0.023 和 0.018 分别）、收缩压（p：0.001、0.001 和 0.001 分别）和舒张压（p：0.001、0.001 和 0.001 分别）均降低。然而，血清肌酐水平无显著变化（p>0.05）。收缩压和舒张压变化与胱抑素 C 水平之间无相关性。
与血清肌酐水平相比，胱抑素 C 是检测早期肾功能障碍更敏感的标志物。奥美沙坦治疗可降低胱抑素 C 水平。因此，奥美沙坦可用于预防高血压患者的肾脏损害，且与血压下降无关。
