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.