Addition of a Nitric Oxide Donor to an Angiotensin II Type 1 Receptor Blocker May Cancel Its Blood Pressure-Lowering Effects

Int Heart J. 2015;56(6):656-60. doi: 10.1536/ihj.15-200. Epub 2015 Nov 6.

Abstract

While physiological levels of nitric oxide (NO) protect the endothelium and have vasodilatory effects, excessive NO has adverse effects on the cardiovascular system. Recently, new NO-releasing pharmacodynamic hybrids of angiotensin II (Ang II) type 1 (AT1) receptor blockers (ARBs) have been developed.We analyzed whether olmesartan with NO-donor side chains (Olm-NO) was superior to olmesartan (Olm) for the control of blood pressure (BP). Although there was no significant difference in binding affinity to AT1 wild-type (WT) receptor between Olm and Olm-NO in a cell-based binding assay, the suppressive effect of Olm-NO on Ang II-induced inositol phosphate (IP) production was significantly weaker than that of Olm in AT1 WT receptor-expressing cells. While Olm had a strong inverse agonistic effect on IP production, Olm-NO did not. Next, we divided 18 C57BL mice into 3 groups: Ang II (infusion using an osmotic mini-pump) as a control group, Ang II (n = 6) + Olm, and Ang II (n = 6) + Olm-NO groups (n = 6). Olm-NO did not block Ang II-induced high BP after 10 days, whereas Olm significantly decreased BP. In addition, Olm, but not Olm-NO, significantly reduced the ratio of heart weight to body weight (HW/BW) with downregulation of the mRNA levels of atrial natriuretic peptide.An ARB with a NO-donor may cancel BP-lowering effects probably due to excessive NO and a weak blocking effect by Olm-NO toward AT1 receptor activation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin II Type 1 Receptor Blockers / chemistry
  • Angiotensin II Type 1 Receptor Blockers / pharmacology
  • Animals
  • Blood Pressure / drug effects*
  • Cell Culture Techniques
  • Hypotension* / chemically induced
  • Hypotension* / metabolism
  • Hypotension* / prevention & control
  • Imidazoles* / chemistry
  • Imidazoles* / pharmacology
  • Inositol Phosphates / metabolism
  • Mice
  • Mice, Inbred C57BL
  • Nitric Oxide / metabolism
  • Nitric Oxide Donors / chemistry
  • Nitric Oxide Donors / pharmacology
  • Tetrazoles* / chemistry
  • Tetrazoles* / pharmacology

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Imidazoles
  • Inositol Phosphates
  • Nitric Oxide Donors
  • Tetrazoles
  • Nitric Oxide
  • olmesartan