Skip to main content
SpringerLink
Log in

Effects of a changeover from other angiotensin II receptor blockers to olmesartan on left ventricular hypertrophy in heart failure patients

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Left ventricular (LV) hypertrophy (LVH) is an independent cardiovascular risk factor for heart failure (HF) patients. The renin–angiotensin system plays a key role in LVH, and since olmesartan increases plasma angiotensin-(1–7) through an increase in angiotensin-converting enzyme-related carboxypeptidase (ACE2) expression, it was hypothesized to reduce LVH, unlike other angiotensin II receptor blockers (ARBs). The objective of this study was therefore to investigate the effects of a changeover from other ARBs to olmesartan on LVH in HF patients. Participants enrolled in this prospective trial were 64 outpatients with stable HF who had received ARBs other than olmesartan for more than 1 year (age: 59 ± 13 years). Transthoracic echocardiography and laboratory tests were performed before and 6 months after administration of olmesartan. Other drugs were not changed during follow-up. The primary end point was defined as a change in LV mass index (LVMI) from baseline up to 6 months after administration of olmesartan. No significant changes were observed in blood pressures and heart rate after administration of olmesartan. LVMI showed a significant decrease from 119 ± 38 to 110 ± 24 g/m2 (p = 0.007) 6 months after administration of olmesartan, and further decreased from 110 ± 24 to 103 ± 35 g/m2 (p = 0.0003) after 12 months. Moreover, this reduction tended to be more prominent in patients with LVH. In conclusions, LVH in HF patients was reduced by the changeover to olmesartan. This finding may well have clinical implications for better management of HF patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322:1561–1566

    Article  CAS  PubMed  Google Scholar 

  2. Ghali JK, Liao Y, Simmons B, Castaner A, Cao G, Cooper RS (1992) The prognostic role of left ventricular hypertrophy in patients with or without coronary artery disease. Ann Intern Med 117:831–836

    Article  CAS  PubMed  Google Scholar 

  3. Verdecchia P, Carini G, Circo A, Dovellini E, Giovannini E, Lombardo M, Solinas P, Gorini M, Maggioni AP, Group MS (2001) Left ventricular mass and cardiovascular morbidity in essential hypertension: the MAVI study. J Am Coll Cardiol 38:1829–1835

  4. Klingbeil AU, Schneider M, Martus P, Messerli FH, Schmieder RE (2003) A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med 115:41–46

    Article  PubMed  Google Scholar 

  5. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Drazner MH, Fonarow GC, Geraci SA, Horwich T, Januzzi JL, Johnson MR, Kasper EK, Levy WC, Masoudi FA, McBride PE, McMurray JJ, Mitchell JE, Peterson PN, Riegel B, Sam F, Stevenson LW, Tang WH, Tsai EJ, Wilkoff BL (2013) 2013 ACCF/AHA guideline for the management of heart failure: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation 128:1810–1852

    Article  PubMed  Google Scholar 

  6. De Mello WC, Danser AH (2000) Angiotensin II and the heart: on the intracrine renin-angiotensin system. Hypertension 35:1183–1188

    Article  PubMed  Google Scholar 

  7. Schieffer B, Wirger A, Meybrunn M, Seitz S, Holtz J, Riede UN, Drexler H (1994) Comparative effects of chronic angiotensin-converting enzyme inhibition and angiotensin II type 1 receptor blockade on cardiac remodeling after myocardial infarction in the rat. Circulation 89:2273–2282

    Article  CAS  PubMed  Google Scholar 

  8. Liu Y, Leri A, Li B, Wang X, Cheng W, Kajstura J, Anversa P (1998) Angiotensin II stimulation in vitro induces hypertrophy of normal and postinfarcted ventricular myocytes. Circ Res 82:1145–1159

    Article  CAS  PubMed  Google Scholar 

  9. Wang X, Yuan B, Dong W, Yang B, Yang Y, Lin X, Gong G (2015) Humid heat exposure induced oxidative stress and apoptosis in cardiomyocytes through the angiotensin II signaling pathway. Heart Vessels 30:396–405

    Article  PubMed  Google Scholar 

  10. Nakada Y, Takahama H, Kanzaki H, Sugano Y, Hasegawa T, Ohara T, Amaki M, Funada A, Yoshida A, Yasuda S, Ogawa H, Anzai T (2016) The predictability of renin-angiotensin-aldosterone system factors for clinical outcome in patients with acute decompensated heart failure. Heart Vessels 31:925–931

    Article  PubMed  Google Scholar 

  11. Donoghue M, Hsieh F, Baronas E, Godbout K, Gosselin M, Stagliano N, Donovan M, Woolf B, Robison K, Jeyaseelan R, Breitbart RE, Acton S (2000) A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1-9. Circ Res 87:E1–E9

    Article  CAS  PubMed  Google Scholar 

  12. Turner AJ, Tipnis SR, Guy JL, Rice G, Hooper NM (2002) ACEH/ACE2 is a novel mammalian metallocarboxypeptidase and a homologue of angiotensin-converting enzyme insensitive to ACE inhibitors. Can J Physiol Pharmacol 80:346–353

    Article  CAS  PubMed  Google Scholar 

  13. Turner AJ, Hooper NM (2002) The angiotensin-converting enzyme gene family: genomics and pharmacology. Trends Pharmacol Sci 23:177–183

    Article  CAS  PubMed  Google Scholar 

  14. Ferrario CM, Chappell MC, Tallant EA, Brosnihan KB, Diz DI (1997) Counterregulatory actions of angiotensin-(1-7). Hypertension 30:535–541

    Article  CAS  PubMed  Google Scholar 

  15. Ferrario CM, Iyer SN (1998) Angiotensin-(1-7): a bioactive fragment of the renin-angiotensin system. Regul Pept 78:13–18

    Article  CAS  PubMed  Google Scholar 

  16. Vickers C, Hales P, Kaushik V, Dick L, Gavin J, Tang J, Godbout K, Parsons T, Baronas E, Hsieh F, Acton S, Patane M, Nichols A, Tummino P (2002) Hydrolysis of biological peptides by human angiotensin-converting enzyme-related carboxypeptidase. J Biol Chem 277:14838–14843

    Article  CAS  PubMed  Google Scholar 

  17. Ishiyama Y, Gallagher PE, Averill DB, Tallant EA, Brosnihan KB, Ferrario CM (2004) Upregulation of angiotensin-converting enzyme 2 after myocardial infarction by blockade of angiotensin II receptors. Hypertension 43:970–976

    Article  CAS  PubMed  Google Scholar 

  18. Resnick LM, Catanzaro D, Sealey JE, Laragh JH (2004) Acute vascular effects of the angiotensin II receptor antagonist olmesartan in normal subjects: relation to the renin-aldosterone system. Am J Hypertens 17:203–208

    Article  CAS  PubMed  Google Scholar 

  19. Kaiqiang J, Minakawa M, Fukui K, Suzuki Y, Fukuda I (2009) Olmesartan improves left ventricular function in pressure-overload hypertrophied rat heart by blocking angiotensin II receptor with synergic effects of upregulation of angiotensin converting enzyme 2. Ther Adv Cardiovasc Dis 3:103–111

    Article  Google Scholar 

  20. Arumugam S, Thandavarayan RA, Palaniyandi SS, Giridharan VV, Arozal W, Sari FR, Soetikno V, Harima M, Suzuki K, Kodama M, Watanabe K (2012) Candesartan cilexetil protects from cardiac myosin induced cardiotoxicity via reduction of endoplasmic reticulum stress and apoptosis in rats: involvement of ACE2-Ang (1-7)-mas axis. Toxicology 291:139–145

    Article  CAS  PubMed  Google Scholar 

  21. Sukumaran V, Veeraveedu PT, Gurusamy N, Lakshmanan AP, Yamaguchi K, Ma M, Suzuki K, Kodama M, Watanabe K (2012) Telmisartan acts through the modulation of ACE-2/ANG 1-7/mas receptor in rats with dilated cardiomyopathy induced by experimental autoimmune myocarditis. Life Sci 90:289–300

    Article  CAS  PubMed  Google Scholar 

  22. Arakawa K, Iimura O, Abe K, Saruta T, Ishii M, Ogihara T, Hiwada K, Fujishima M, Fukiyama K, Nobutomo K (2002) Hypotensive effect and safety of TCV-116 (candesartan cilexetil), a new angiotensin receptor antagonist, in patients with essential hypertension—clinical late phase II study. J Clin Therap Med 14:2765–2800

    Google Scholar 

  23. Yoshinaga K, Abe K, Iimura O, Saruta T, Yazaki Y, Ishii M, Mizuno Y, Ogihara T, Takeda T, Arakawa K, Fukiyama K (1994) Efficacy and safety of MK-954 (losartan potassium), a new angiotensin II receptor antagonist, in patients with essential hypertension. J Clin Therap Med 10:49–78

    Google Scholar 

  24. Arakawa K, Shimamoto K, Abe K, Saruta T, Ishii M, Ogihara T, Hiwada K, Fujishima M, Fukiyama K (2003) The optimal dose of CS-866 (Olmesartan Medoxomil), a novel angiotensin II receptor antagonist, in patients with mild-to-moderate essential hypertension. J Clin Therap Med 19:1001–1028

    Google Scholar 

  25. Yoshinaga K, Ogihara T, Iihara O, Abe K, Saruta T, Yazaki Y, Arakawa M, Hiwada K, Arakawa K, Fukiyama K (1998) Clinical evaluation of GCP 48933 (Valsartan), a new angiotensin receptor antagonist, in patients with essential hypertension. J Clin Therap Med 10:1787–1814

    Google Scholar 

  26. Ogihara T, Minami F, Kainuma H, Asai Y, Okada Y, Fukuyo K, Nakamura Y, Osaka A (2002) Pharmacokinetic evaluation of an angiotensin II AT1 receptor antagonist, BIBR277 (Telmisartan) in hypertensive patients. Jpn Pharmacol Ther 14:S103–S119

    Google Scholar 

  27. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 28(1–39):e14

    Google Scholar 

  28. Nagueh SF, Smiseth OA, Appleton CP, Byrd BF 3rd, Dokainish H, Edvardsen T, Flachskampf FA, Gillebert TC, Klein AL, Lancellotti P, Marino P, Oh JK, Popescu BA, Waggoner AD (2016) Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the american society of echocardiography and the european association of cardiovascular imaging. J Am Soc Echocardiogr 29:277–314

    Article  PubMed  Google Scholar 

  29. Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458

    Article  CAS  PubMed  Google Scholar 

  30. Liu YH, Yang XP, Sharov VG, Nass O, Sabbah HN, Peterson E, Carretero OA (1997) Effects of angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor antagonists in rats with heart failure. Role of kinins and angiotensin II type 2 receptors. J Clin Invest 99:1926–1935

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Kim S, Iwao H (2000) Molecular and cellular mechanisms of angiotensin II-mediated cardiovascular and renal diseases. Pharmacol Rev 52:11–34

    CAS  PubMed  Google Scholar 

  32. Agata J, Ura N, Yoshida H, Shinshi Y, Sasaki H, Hyakkoku M, Taniguchi S, Shimamoto K (2006) Olmesartan is an angiotensin II receptor blocker with an inhibitory effect on angiotensin-converting enzyme. Hypertens Res 29:865–874

    Article  CAS  PubMed  Google Scholar 

  33. Igase M, Strawn WB, Gallagher PE, Geary RL, Ferrario CM (2005) Angiotensin II AT1 receptors regulate ACE2 and angiotensin-(1-7) expression in the aorta of spontaneously hypertensive rats. Am J Physiol Heart Circ Physiol 289:H1013–H1019

    Article  CAS  PubMed  Google Scholar 

  34. Yokoyama H, Averill DB, Brosnihan KB, Smith RD, Schiffrin EL, Ferrario CM (2005) Role of blood pressure reduction in prevention of cardiac and vascular hypertrophy. Am J Hypertens 18:922–929

    Article  PubMed  Google Scholar 

  35. Sato A, Hayashi K, Naruse M, Saruta T (2003) Effectiveness of aldosterone blockade in patients with diabetic nephropathy. Hypertension 41:64–68

    Article  CAS  PubMed  Google Scholar 

  36. McKelvie RS, Yusuf S, Pericak D, Avezum A, Burns RJ, Probstfield J, Tsuyuki RT, White M, Rouleau J, Latini R, Maggioni A, Young J, Pogue J (1999) Comparison of candesartan, enalapril, and their combination in congestive heart failure: randomized evaluation of strategies for left ventricular dysfunction (RESOLVD) pilot study. The RESOLVD Pilot Study Investigators. Circulation 100:1056–1064

    CAS  PubMed  Google Scholar 

  37. Cohn JN, Anand IS, Latini R, Masson S, Chiang YT, Glazer R (2003) Sustained reduction of aldosterone in response to the angiotensin receptor blocker valsartan in patients with chronic heart failure: results from the Valsartan Heart Failure Trial. Circulation 108:1306–1309

    Article  CAS  PubMed  Google Scholar 

  38. Sezai A, Soma M, Hata M, Yoshitake I, Unosawa S, Wakui S, Shiono M (2011) Effects of olmesartan on the renin-angiotensin-aldosterone system for patients with essential hypertension after cardiac surgery-investigation using a candesartan change-over study. Ann Thorac Cardiovasc Surg 17:487–493

    Article  PubMed  Google Scholar 

  39. Tsutamoto T, Nishiyama K, Yamaji M, Kawahara C, Fujii M, Yamamoto T, Horie M (2010) Comparison of the long-term effects of candesartan and olmesartan on plasma angiotensin II and left ventricular mass index in patients with hypertension. Hypertens Res 33:118–122

    Article  CAS  PubMed  Google Scholar 

  40. Zile MR, Gottdiener JS, Hetzel SJ, McMurray JJ, Komajda M, McKelvie R, Baicu CF, Massie BM, Carson PE, Investigators IP (2011) Prevalence and significance of alterations in cardiac structure and function in patients with heart failure and a preserved ejection fraction. Circulation 124:2491–2501

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful for the support of the entire staff of the echocardiography laboratories of the Kobe University Hospital.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan

    Hiroyuki Shimoura, Hidekazu Tanaka, Kensuke Matsumoto, Yasuhide Mochizuki, Yutaka Hatani, Keiko Hatazawa, Hiroki Matsuzoe, Junichi Ooka, Hiroyuki Sano, Takuma Sawa, Yoshiki Motoji, Keiko Ryo-Koriyama & Ken-ichi Hirata

Authors
  1. Hiroyuki Shimoura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hidekazu Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kensuke Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yasuhide Mochizuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yutaka Hatani
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Keiko Hatazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Hiroki Matsuzoe
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Junichi Ooka
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hiroyuki Sano
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Takuma Sawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Yoshiki Motoji
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Keiko Ryo-Koriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Ken-ichi Hirata
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hidekazu Tanaka.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shimoura, H., Tanaka, H., Matsumoto, K. et al. Effects of a changeover from other angiotensin II receptor blockers to olmesartan on left ventricular hypertrophy in heart failure patients. Heart Vessels 32, 584–590 (2017). https://doi.org/10.1007/s00380-016-0904-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-016-0904-0

Keywords

Search

Navigation