The objective of the present study was to determine the autonomic effects of angiotensin II (AT1) receptor blocker therapy in heart failure. In a randomized double-blind cross-over study, we compared the effects of candesartan and placebo on baroreflex sensitivity and on heart rate variability at rest, during stress and during 24h monitoring. Acute effects were assessed 4h after oral candesartan (8mg) and chronic effects after 4 weeks of treatment (dose titrated to 16mg daily). The study group comprised 21 patients with heart failure [mean (S.E.M.) ejection fraction 33% (1%)], in the absence of angiotensin-converting enzyme (ACE) inhibitor therapy. We found that acute candesartan was not different from placebo in its effects on blood pressure or mean RR interval. Chronic candesartan significantly reduced blood pressure [placebo, 137 (3)/82 (3)mmHg; candesartan, 121 (4)/75 (2)mmHg; P<0.001; values are mean (S.E.M.)], but had no effect on mean RR interval [placebo, 857 (25)ms; candesartan, 857 (21)ms]. Compared with placebo there were no significant effects of acute or chronic candesartan on heart rate variability in the time domain and no consistent effects in the frequency domain. Baroreflex sensitivity assessed by the phenylephrine bolus method was significantly increased after chronic candesartan [placebo, 3.5 (0.5)ms/mmHg; candesartan, 4.8 (0.7)ms/mmHg; P<0.05], although there were no changes in cross-spectral baroreflex sensitivity. Thus, in contrast with previous results with ACE inhibitors, angiotensin II receptor blockade in heart failure did not increase heart rate variability, and there was no consistent effect on baroreflex sensitivity.
Skip Nav Destination
Article navigation
Research Article|
October 24 2001
Effects of angiotensin II (AT1) receptor blockade on cardiac vagal control in heart failure
J. C. VAILE;
J. C. VAILE
*Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
Search for other works by this author on:
S. CHOWDHARY;
S. CHOWDHARY
*Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
Search for other works by this author on:
F. OSMAN;
F. OSMAN
*Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
Search for other works by this author on:
H. F. ROSS;
H. F. ROSS
†Department of Physiology, University of Birmingham, Birmingham B15 2TH, U.K.
Search for other works by this author on:
J. FLETCHER;
J. FLETCHER
†Department of Physiology, University of Birmingham, Birmingham B15 2TH, U.K.
Search for other works by this author on:
W. A. LITTLER;
W. A. LITTLER
*Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
Search for other works by this author on:
J. H. COOTE;
J. H. COOTE
†Department of Physiology, University of Birmingham, Birmingham B15 2TH, U.K.
Search for other works by this author on:
J. N. TOWNEND
*Department of Cardiovascular Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2TH, U.K.
Correspondence: Dr J. N. Townend (e-mail [email protected]).
Search for other works by this author on:
Publisher: Portland Press Ltd
Received:
March 02 2001
Revision Received:
June 05 2001
Accepted:
July 20 2001
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society and the Medical Research Society © 2001
2001
Clin Sci (Lond) (2001) 101 (6): 559–566.
Article history
Received:
March 02 2001
Revision Received:
June 05 2001
Accepted:
July 20 2001
Citation
J. C. VAILE, S. CHOWDHARY, F. OSMAN, H. F. ROSS, J. FLETCHER, W. A. LITTLER, J. H. COOTE, J. N. TOWNEND; Effects of angiotensin II (AT1) receptor blockade on cardiac vagal control in heart failure. Clin Sci (Lond) 1 December 2001; 101 (6): 559–566. doi: https://doi.org/10.1042/cs1010559
Download citation file:
Sign in
Don't already have an account? Register
Sign in to your personal account
You could not be signed in. Please check your email address / username and password and try again.
Could not validate captcha. Please try again.
Biochemical Society Member Sign in
Sign InSign in via your Institution
Sign in via your InstitutionGet Access To This Article
Cited By
Open Access for all
We offer compliant routes for all authors from 2025. With library support, there will be no author nor reader charges in 5 journals. Check here |
![]() |