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Advanced glycation end‐products, anti‐hypertensive treatment and diastolic function in patients with hypertension and diastolic dysfunction
Author(s) -
Hartog Jasper W.L.,
Wal Ruud M.,
Schalkwijk Casper G.,
Miyata Toshio,
Jaarsma Wybren,
Plokker H.W. Thijs,
Wijk Leen M.,
Smit Andries J.,
Veldhuisen Dirk J.,
Voors Adriaan A.
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq001
Subject(s) - medicine , diastole , glycation , cardiology , blood pressure , pentosidine , diastolic function , receptor
Aims To investigate the relationship between advanced glycation end‐products (AGEs) and diastolic function and the response to blood pressure treatment in patients with hypertension and diastolic dysfunction. Methods and results Data were analysed from 97 patients (aged 65 ± 10 years, 36% male) who were randomly assigned to 6 months open‐label treatment with either eprosartan on top of other anti‐hypertensive drugs ( n = 47) or other anti‐hypertensive drugs alone ( n = 50). Tissue AGE accumulation was measured using a validated skin‐autofluorescence (skin‐AF) reader ( n = 26). Plasma N ɛ ‐(carboxymethyl)lysine (CML), N ɛ ‐(carboxyethyl)lysine (CEL), and pentosidine were measured by LC‐MS/MS and HPLC. Diastolic function was assessed using echocardiography. Blood pressure was reduced from 157/91 to 145/84 mmHg ( P < 0.001) in the eprosartan group and from 158/91 to 141/83 mmHg ( P < 0.001) in the control group. No effect of eprosartan was found on AGE levels. In patients with baseline skin‐AF < median, E/A ratio ( P = 0.04) and the mean peak early‐diastolic filling velocity (E′) improved ( P = 0.001). In contrast, in patients with skin‐AF levels > median, E/A ratio ( P = 0.84) and mean E′ ( P = 0.32) remained unchanged. Conclusion Although eprosartan did not decrease levels of AGEs, patients with lower skin‐AF at baseline showed a larger improvement in diastolic function in response to either anti‐hypertensive treatment compared with patients with higher skin‐AF.