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Angiotensin II blockers in obstructive pulmonary disease: a randomised controlled trial
S Andreas1, C Herrmann-Lingen, T Raupach
1Lungenfachklinik Immenhausen, Robert-Koch-Str. 3, 34376 Immenhausen, Germany. sandreas@med.uni-goettingen.de
The European Respiratory Journal
|February 1, 2006
Summary
Angiotensin II receptor blockers did not improve respiratory muscle strength in chronic obstructive pulmonary disease (COPD) patients. However, irbesartan may offer unexpected benefits, reducing haematocrit and total lung capacity in COPD.
Area of Science:
- Pulmonary Medicine
- Cardiovascular Pharmacology
Background:
- Chronic obstructive pulmonary disease (COPD) involves sympathetic and renin-angiotensin system activation, potentially impacting skeletal muscles.
- Angiotensin II type-1 receptor blockers (ARBs) can modulate these systems, suggesting a potential benefit for muscle strength in COPD.
Purpose of the Study:
- To evaluate the effect of the ARB irbesartan on respiratory and skeletal muscle strength in COPD patients.
- To assess the impact of irbesartan on spirometry, lung volumes, and hematocrit in COPD.
Main Methods:
- A 4-month randomized trial involving 60 COPD patients with reduced forced expiratory volume in one second.
- Patients received either irbesartan or a placebo, excluding those with cardiovascular conditions requiring ACE inhibitors or ARBs.
Main Results:
- Irbesartan was well-tolerated but did not significantly improve maximum inspiratory pressure (primary endpoint).
- No significant changes in spirometry were observed, but total lung capacity decreased.
- A significant reduction in hematocrit was noted in the irbesartan group compared to placebo.
Conclusions:
- Angiotensin II receptor blockade with irbesartan did not enhance respiratory muscle strength in COPD patients.
- Observed changes in hematocrit and total lung capacity suggest potential, unanticipated benefits of cardiovascular drugs in COPD management.