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Effects of olmesartan on blood pressure and insulin resistance in hypertensive patients with sleep-disordered breathing

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Abstract

The increased risk of cardiovascular morbidity and mortality among patients with sleep-disordered breathing (SDB) has been linked to arterial hypertension and insulin resistance. However, an effective antihypertensive agent for patients with SDB has not been identified. We investigated the effect of the angiotensin II subtype 1 receptor blocker olmesartan in hypertensive patients with SDB. This prospective, one-arm pilot study included 25 male patients with untreated SDB (mean age, 52.7 ± 11.4 years). We measured blood pressure, oxygen desaturation index (ODI), cardiac function using echocardiography, and insulin resistance using the homeostasis model assessment (HOMA) before and after 12 weeks of olmesartan therapy (mean dose, 17.6 ± 4.4 mg/day). Olmesartan significantly decreased systolic blood pressure (151.4 ± 8.0 vs 134.0 ± 7.4 mmHg; P < 0.001), diastolic blood pressure (93.4 ± 7.1 vs 83.9 ± 6.3 mmHg; P < 0.001), and HOMA index (3.7 ± 2.9 vs 2.8 ± 1.9; P = 0.012). Furthermore, left ventricular ejection fraction significantly increased at 12 weeks (68.1 ± 5.1 vs 71.6 ± 5.4%; P = 0.009). However, body mass index (BMI) and degree of SDB did not change (BMI, 26.6 ± 4.0 vs 26.6 ± 4.2 kg/m2, P = 0.129; 3% ODI, 29.5 ± 23.1 vs 28.2 ± 21.0 events/h, P = 0.394). Olmesartan significantly reduced blood pressure and insulin resistance in hypertensive patients with SDB without changing BMI or SDB severity.

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Acknowledgments

The authors are grateful to the staff of the sleep center at Toranomon Hospital.

Conflict of interest

No author has any conflict of interest associated with this article.

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Authors and Affiliations

  1. Cardiovascular Center, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan

    Tomotaka Dohi, Sugao Ishiwata, Minoru Ohno & Tetsu Yamaguchi

  2. Sleep Center, Toranomon Hospital, Tokyo, Japan

    Koji Narui, Takatoshi Kasai, Hisashi Takaya, Ayako Inoshita, Kenichi Maeno & Satoshi Kasagi

  3. Saitama Medical Center, Jichi Medical University, Saitama, Japan

    Shin-ichi Momomura

Authors
  1. Tomotaka Dohi
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  2. Koji Narui
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  3. Takatoshi Kasai
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  4. Hisashi Takaya
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  5. Ayako Inoshita
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  6. Kenichi Maeno
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Correspondence to Tomotaka Dohi.

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Dohi, T., Narui, K., Kasai, T. et al. Effects of olmesartan on blood pressure and insulin resistance in hypertensive patients with sleep-disordered breathing. Heart Vessels 26, 603–608 (2011). https://doi.org/10.1007/s00380-010-0104-2

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  • DOI: https://doi.org/10.1007/s00380-010-0104-2

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