Effects of atenolol or losartan on fibrinolysis and von Willebrand factor in hypertensive patients with left ventricular hypertrophy.

OBJECTIVES: To compare the effects of the beta-blocker atenolol with the angiotensin receptor blocker (ARB) losartan on plasma tissue-type plasminogen activator (tPA) activity and mass concentration, plasminogen activator inhibitor-1 (PAI-1) activity, tPA/PAI-1 complex, and von Willebrand factor (VWF). DESIGN: A prespecified, explorative substudy in 22 patients with hypertension and left ventricular hypertrophy (LVH) performed within randomized multicenter, double-blind prospective study. RESULTS: After a median of 36 weeks of treatment, there were significant differences between the treatment groups, atenolol versus losartan, in plasma median levels of tPA mass (11.9 vs 7.3 ng/mL, P = .019), PAI-1 activity (20.7 vs 4.8 IU/mL, P = .030), and tPA/PAI-1 complex (7.1 vs 2.5 ng/mL, P = .015). In patients treated with atenolol, median levels of tPA mass (8.9-11.9 ng/mL, P = .021) and VWF (113.5%-134.3%, P = .021) increased significantly, indicating a change toward a more prothrombotic state. No significant changes occurred in the losartan group. CONCLUSION: Losartan treatment was associated with preserved fibrinolytic balance compared to a more prothrombotic fibrinolytic and hemostatic state in the atenolol group. These findings suggest different fibrinolytic and hemostatic responses to treatment in hypertensive patients with LVH.

Boman, Jenny HernestålUmeå universitet,Medicin(Swepub:umu)jeyhel99 (author)
Andersson, Jonas,1977-Umeå universitet,Medicin(Swepub:umu)jasaon96 (author)
Olofsson, Mona,1952-Umeå universitet,Medicin(Swepub:umu)mool0019 (author)
Dahlöf, Björn,1953Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine(Swepub:gu)xdahbj (author)
Umeå universitetMedicin (creator_code:org_t)

In:Clinical and applied thrombosis/hemostasis: SAGE Publications16:2, s. 146-1521076-02961938-2723

By the author/editor: Boman, Kurt; Boman, Jenny Her ...; Andersson, Jonas ...; Olofsson, Mona, ...; Dahlöf, Björn, 1 ...

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