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The impact of angiotensin II receptor blockade and the DASH diet on markers of endogenous fibrinolysis

Journal of Human Hypertension volume 16, pages 391–397 (2002)Cite this article

Abstract

Hypertension is associated with impaired fibrinolysis. Both angiotensin receptor blockers (ARB) and the DASH (Dietary Approaches to Stop Hypertension) diet effectively lower blood pressure in hypertensive patients. Some evidence suggests that treatment with ARBs could increase fibrinolysis, however, data is conflicting. The impact of the DASH diet on fibrinolytic parameters is not known. Fifty-five hypertensive participants (35 African-American, 20 white) were randomly assigned to receive 8 weeks of either a control diet or the DASH diet. The diets did not differ in sodium content (approximately 3 g/day). Within each diet, individuals were randomly assigned to receive losartan or placebo for 4 weeks in double-blind, cross-over fashion. Tissue plasminogen activator (t-PA) antigen, t-PA activity, plasminogen activator inhibitor-1 (PAI-1) activity and plasma renin activity (PRA) were measured at the end of a 2-week run-in period on the control diet and after each treatment period. The DASH diet did not affect markers of fibrinolysis. Losartan significantly lowered t-PA antigen levels (−1.8 ng/mL, P = 0.045), but had no effect on t-PA or PAI-1 activities. This effect was more pronounced in whites (−4.1 ng/mL (P = 0.003)) compared with African-Americans (−0.3 ng/mL (P = 0.7), P-interaction = 0.03). Results were not materially affected by adjustment for basline values or changes in blood pressure. This study demonstrates that losartan reduces t-PA antigen levels in white, but not African-American hypertensive individuals. In contrast, the DASH diet had no significant effect on markers of fibrinolysis in whites or African-Americans.

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Acknowledgements

We would like to thank the participants and staff, whose hard work and dedication made this work possible. We would also like to acknowledge the Baltimore VA Geriatrics Research, Education, and Clinical Center (GRECC). This work was supported by a grant from the National Institutes of Health (T32PE10025) and a grant from Merck and Company, Inc.

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Authors and Affiliations

  1. Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA

    T P Erlinger, E R Miller, III & L J Appel

  2. Department of Neurology and Division of Gerontology, Baltimore V.A. Medical Center and University of Maryland, Baltimore, MD, USA

    P R Conlin & R F Macko

  3. Department of Medicine, Boston University, Boston, MA, USA

    A D Bohannon & T J Moore

  4. Department of Medicine, Duke University School of Medicine, Durham, NC, USA

    L P Svetkey

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  1. T P Erlinger
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  2. P R Conlin
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Correspondence to T P Erlinger.

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5Endocrinology-Hypertension Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

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Erlinger, T., Conlin, P., Macko, R. et al. The impact of angiotensin II receptor blockade and the DASH diet on markers of endogenous fibrinolysis. J Hum Hypertens 16, 391–397 (2002). https://doi.org/10.1038/sj.jhh.1001401

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