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Conference Paper: Randomised trial of candesartan and enalapril (RACE) in the treatment of hypertension-final results

TitleRandomised trial of candesartan and enalapril (RACE) in the treatment of hypertension-final results
Authors
Issue Date2003
PublisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org
Citation
The 8th Medical Research Conference of Department of Medicine, The University of Hong Kong, Hong Kong, 25 – 26 January 2003. In Hong Kong Medical Journal, 2003, v. 9 n. S1, p. 24 How to Cite?
AbstractIntroduction: The renin-angiotensin system plays an important part in the pathophysiology of hypertension. We compared two ways of blocking the system, using an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker. Method: 22 hypertensive patients (16 men, 6 women; age 47±10 yrs) were randomised to either candesartan 8 mg or enalapril 10 mg daily for 3 months. The dose could be doubled after 6 weeks for blood pressure control. Ambulatory blood pressure monitoring was performed before randomisation and before the final visit. Echocardiography was performed at randomization, 2 and 12 weeks. Flowmediated dilatation was measured at the brachial artery to assess endothelial function. Exhaled nitric oxide was measured using an integrated chemiluminescent system. The coefficient of variation of left ventricular mass index (LVMI), flow-mediated dilatation (FMD) and nitric oxide measurement were 7%, 5% and 3% respectively. Results: Candesartan and enalapril both significantly lowered systolic and diastolic blood pressure. This was confirmed by ambulatory blood pressure monitoring. There were no significant differences between the treatments in their effect on LVMI and exhaled nitric oxide. Changes in LVMI correlated strongly with changes in the ambulatory systolic blood pressure (r=0.62, p=0.02) and diastolic blood pressure (r=0.61, p=0.02). FMD increased with enalapril but not candesartan treatment (p=0.04). Neither treatment significantly altered plasma potassium, creatinine, renin and aldosterone. Fasting blood glucose decreased significantly from 5.6±0.4 to 5.1±0.3 mmol/L in the enalapril group (p=0.01) only. Conclusions: Both drugs are efficacious in lowering blood pressure. Candesartan tended to lower blood pressure more than enalapril, which might be the result of the dosages used. Enalapril appears to have a favourable effect on blood glucose and endothelial function. We conclude that candesartan may be used as an alternative to enalapril in the treatment of hypertension, particularly in those who are intolerant of the latter.
Persistent Identifierhttp://hdl.handle.net/10722/101971
ISSN
2015 Impact Factor: 0.887
2015 SCImago Journal Rankings: 0.279

 

DC FieldValueLanguage
dc.contributor.authorCheung, BMYen_HK
dc.contributor.authorLaw, CYen_HK
dc.contributor.authorFung, PCWen_HK
dc.contributor.authorTsang, KWTen_HK
dc.contributor.authorTan, KCBen_HK
dc.contributor.authorKumana, CRen_HK
dc.contributor.authorLau, CPen_HK
dc.date.accessioned2010-09-25T20:11:52Z-
dc.date.available2010-09-25T20:11:52Z-
dc.date.issued2003en_HK
dc.identifier.citationThe 8th Medical Research Conference of Department of Medicine, The University of Hong Kong, Hong Kong, 25 – 26 January 2003. In Hong Kong Medical Journal, 2003, v. 9 n. S1, p. 24en_HK
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/101971-
dc.description.abstractIntroduction: The renin-angiotensin system plays an important part in the pathophysiology of hypertension. We compared two ways of blocking the system, using an angiotensin-converting enzyme inhibitor or an angiotensin II receptor blocker. Method: 22 hypertensive patients (16 men, 6 women; age 47±10 yrs) were randomised to either candesartan 8 mg or enalapril 10 mg daily for 3 months. The dose could be doubled after 6 weeks for blood pressure control. Ambulatory blood pressure monitoring was performed before randomisation and before the final visit. Echocardiography was performed at randomization, 2 and 12 weeks. Flowmediated dilatation was measured at the brachial artery to assess endothelial function. Exhaled nitric oxide was measured using an integrated chemiluminescent system. The coefficient of variation of left ventricular mass index (LVMI), flow-mediated dilatation (FMD) and nitric oxide measurement were 7%, 5% and 3% respectively. Results: Candesartan and enalapril both significantly lowered systolic and diastolic blood pressure. This was confirmed by ambulatory blood pressure monitoring. There were no significant differences between the treatments in their effect on LVMI and exhaled nitric oxide. Changes in LVMI correlated strongly with changes in the ambulatory systolic blood pressure (r=0.62, p=0.02) and diastolic blood pressure (r=0.61, p=0.02). FMD increased with enalapril but not candesartan treatment (p=0.04). Neither treatment significantly altered plasma potassium, creatinine, renin and aldosterone. Fasting blood glucose decreased significantly from 5.6±0.4 to 5.1±0.3 mmol/L in the enalapril group (p=0.01) only. Conclusions: Both drugs are efficacious in lowering blood pressure. Candesartan tended to lower blood pressure more than enalapril, which might be the result of the dosages used. Enalapril appears to have a favourable effect on blood glucose and endothelial function. We conclude that candesartan may be used as an alternative to enalapril in the treatment of hypertension, particularly in those who are intolerant of the latter.-
dc.languageengen_HK
dc.publisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org-
dc.relation.ispartofHong Kong Medical Journalen_HK
dc.titleRandomised trial of candesartan and enalapril (RACE) in the treatment of hypertension-final resultsen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailCheung, BMY: mycheung@hku.hken_HK
dc.identifier.emailFung, PCW: hrspfcw@hku.hken_HK
dc.identifier.emailTsang, KWT: kwttsang@hku.hken_HK
dc.identifier.emailTan, KCB: kcbtan@hku.hken_HK
dc.identifier.emailKumana, CR: hrmekcr@hku.hken_HK
dc.identifier.emailLau, CP: cplau@hku.hken_HK
dc.identifier.authorityTan, KCB=rp00402en_HK
dc.identifier.hkuros82585en_HK
dc.identifier.volume9en_HK

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