P-178: AT-1 receptor antagonism with candesartan cilexitil improves endothelial function in patients with hypertension and coronary artery disease: A double-blind, randomized, placebo-controlled trial

Endothelial dysfunction (ED) predicts adverse prognosis in patients with coronary artery disease (CAD) and in hypertensives (HTN). Since reversibility of ED has been reported to be associated with more favorable prognosis in HTN, evaluation of the effect of therapy on ED maybe clinically relevant. W...

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Published in:American journal of hypertension 2005-05, Vol.18 (S4), p.71A-71A
Main Authors: Filardi, Pasquale Perrone, Brevetti, Gregorio, Silvestro, Antonio, Corrado, Luigi, Cafiero, Maria, Petretta, Andrea, Caiazzo, Gianluca, Polimeno, Michele, Zarrilli, Annamaria, Camerino, Roberta, Maglione, Antonio, Chiariello, Massimo
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Endothelial Function
Hypertension
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container_issue S4
container_start_page 71A
container_title American journal of hypertension
container_volume 18
creator Filardi, Pasquale Perrone
Brevetti, Gregorio
Silvestro, Antonio
Corrado, Luigi
Cafiero, Maria
Petretta, Andrea
Caiazzo, Gianluca
Polimeno, Michele
Zarrilli, Annamaria
Camerino, Roberta
Maglione, Antonio
Chiariello, Massimo
description Endothelial dysfunction (ED) predicts adverse prognosis in patients with coronary artery disease (CAD) and in hypertensives (HTN). Since reversibility of ED has been reported to be associated with more favorable prognosis in HTN, evaluation of the effect of therapy on ED maybe clinically relevant. We studied 28 patients (27 men) with controlled HTN and stable asymptomatic CAD while on beta-blocker and nitrate therapy, with evidence of sustained ED assessed by ultrasound measurement of % hyperemic flow-mediated dilation (FMD) of the brachial artery. FMD was evaluated at screening and after a 2 week run-in and only patients with reduced (
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Since reversibility of ED has been reported to be associated with more favorable prognosis in HTN, evaluation of the effect of therapy on ED maybe clinically relevant. We studied 28 patients (27 men) with controlled HTN and stable asymptomatic CAD while on beta-blocker and nitrate therapy, with evidence of sustained ED assessed by ultrasound measurement of % hyperemic flow-mediated dilation (FMD) of the brachial artery. FMD was evaluated at screening and after a 2 week run-in and only patients with reduced (&lt;25th percentile of an age and sex-matched normal population) and stable (variation between the 2 measurements within the reproducibility range) FMD were randomized to a double-blind, 2-month treatment period with either placebo (PL) or candesartan cilexitil (C) 16 mg once-daily on top of usual therapy. No side-effects occurred during the study in either group. At baseline systolic (119+10 vs 126+16 mmHg) and diastolic pressures (79+9 vs 78+8 mmHg) did not significantly differ in the C and PL groups. At the end of treatment diastolic pressure significantly decreased in the C group (72+12; p&lt;0.01 vs baseline). Effects of treatment of endothelial function are reported in the Table below. Placebo (N = 14) Candesartan (N = 14) Baseline 2 Months Baseline 2 Months Brachial artery diameter (mm) 5.04 ± 0.71 5.02 ± 0.65 4.59 ± 0.9 4.48 ± 0.7 Baseline flow (cm/sec) 105 ± 24 102 ± 21 101 ± 28 107 ± 32 Hyperemic flow (cm/sec) 327 ± 88 342 ± 66 360 ± 88 374 ± 63 FMD (%) 4.5 ± 1.9 5.6 ± 2.3 4.8 ± 2.1 7.5 ± 2.9* *differet from baseline p &lt; 0.01 In stable patients with HTN and CAD, with sustained ED despite therapy, C improves ED within 2 months without significant hemodynamic effects. 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At baseline systolic (119+10 vs 126+16 mmHg) and diastolic pressures (79+9 vs 78+8 mmHg) did not significantly differ in the C and PL groups. At the end of treatment diastolic pressure significantly decreased in the C group (72+12; p&lt;0.01 vs baseline). Effects of treatment of endothelial function are reported in the Table below. Placebo (N = 14) Candesartan (N = 14) Baseline 2 Months Baseline 2 Months Brachial artery diameter (mm) 5.04 ± 0.71 5.02 ± 0.65 4.59 ± 0.9 4.48 ± 0.7 Baseline flow (cm/sec) 105 ± 24 102 ± 21 101 ± 28 107 ± 32 Hyperemic flow (cm/sec) 327 ± 88 342 ± 66 360 ± 88 374 ± 63 FMD (%) 4.5 ± 1.9 5.6 ± 2.3 4.8 ± 2.1 7.5 ± 2.9* *differet from baseline p &lt; 0.01 In stable patients with HTN and CAD, with sustained ED despite therapy, C improves ED within 2 months without significant hemodynamic effects. 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Since reversibility of ED has been reported to be associated with more favorable prognosis in HTN, evaluation of the effect of therapy on ED maybe clinically relevant. We studied 28 patients (27 men) with controlled HTN and stable asymptomatic CAD while on beta-blocker and nitrate therapy, with evidence of sustained ED assessed by ultrasound measurement of % hyperemic flow-mediated dilation (FMD) of the brachial artery. FMD was evaluated at screening and after a 2 week run-in and only patients with reduced (&lt;25th percentile of an age and sex-matched normal population) and stable (variation between the 2 measurements within the reproducibility range) FMD were randomized to a double-blind, 2-month treatment period with either placebo (PL) or candesartan cilexitil (C) 16 mg once-daily on top of usual therapy. No side-effects occurred during the study in either group. At baseline systolic (119+10 vs 126+16 mmHg) and diastolic pressures (79+9 vs 78+8 mmHg) did not significantly differ in the C and PL groups. At the end of treatment diastolic pressure significantly decreased in the C group (72+12; p&lt;0.01 vs baseline). Effects of treatment of endothelial function are reported in the Table below. Placebo (N = 14) Candesartan (N = 14) Baseline 2 Months Baseline 2 Months Brachial artery diameter (mm) 5.04 ± 0.71 5.02 ± 0.65 4.59 ± 0.9 4.48 ± 0.7 Baseline flow (cm/sec) 105 ± 24 102 ± 21 101 ± 28 107 ± 32 Hyperemic flow (cm/sec) 327 ± 88 342 ± 66 360 ± 88 374 ± 63 FMD (%) 4.5 ± 1.9 5.6 ± 2.3 4.8 ± 2.1 7.5 ± 2.9* *differet from baseline p &lt; 0.01 In stable patients with HTN and CAD, with sustained ED despite therapy, C improves ED within 2 months without significant hemodynamic effects. This action may favourably influence cardiovascular risk profile in such patients.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><doi>10.1016/j.amjhyper.2005.03.196</doi></addata></record>
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subjects Endothelial Function
Hypertension
title P-178: AT-1 receptor antagonism with candesartan cilexitil improves endothelial function in patients with hypertension and coronary artery disease: A double-blind, randomized, placebo-controlled trial
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