Olmesartan medoxomil treatment is associated with decreased plasma B-type natriuretic peptide levels in patients on hemodialysis.

BACKGROUND

High levels of plasma B-type natriuretic peptide (BNP) are associated with cardiac heart failure and death among patients on hemodialysis (HD). A recent study has demonstrated that the angiotensin II type 1 receptor blocker lowers BNP concentrations. Here, we examined whether the ability of olmesartan medoxomil (OM; a novel angiotensin II type 1 receptor blocker) to decrease plasma BNP levels is concentration dependent in hypertensive patients on HD.

METHODS

This preliminary, observational, open-labeled prospective study included 24 patients on HD who were assigned to one group treated with OM (n = 14) or to an age-matched control group that was conventionally treated (n = 10). Blood pressure (BP) was monitored in the morning and evening of a non-HD day and before each HD session, and plasma BNP, plasma aldosterone (PAC), plasma active renin (PARC), and OM concentrations were measured at baseline, 4, and 8 weeks after treatment.

RESULTS

Plasma BNP levels were significantly decreased in the OM group, but remained unchanged in the control group after 4 and 8 weeks of treatment. Compared with the control group, OM was associated with increased PARC and decreased PAC levels. The OM concentrations at 4 and 8 weeks significantly correlated with depressed plasma BNP levels in accordance with multiple regression analysis adjusted for confounders including BP.

CONCLUSION

These results suggest that OM can help to decrease plasma BNP levels via a concentration-dependent effect in patients on HD.