Effect of the angiotensin II type 1 receptor blocker candesartan on endothelial function in patients with essential

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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

L Ghiadoni1, A Virdis, A Magagna

  • 1Department of Internal Medicine, University of Pisa, Pisa, Italy.

Hypertension (Dallas, Tex. : 1979)
|January 21, 2000
PubMed

Insights

Candesartan treatment improved endothelial function in hypertensive patients by enhancing nitric oxide release and reducing endothelin-1-induced vasoconstriction. This study shows the benefits of angiotensin II receptor blockers for hypertension management.

Area of Science:

  • Cardiovascular Pharmacology
  • Endothelial Function
  • Hypertension Research

Background:

  • Essential hypertension is linked to impaired nitric oxide (NO) release and increased endothelin-1 (ET-1) vasoconstriction.
  • Endothelial dysfunction contributes significantly to the pathophysiology of hypertension.

Purpose of the Study:

  • To evaluate the effect of candesartan, an angiotensin II type 1 receptor blocker (ARB), on endothelial function in hypertensive patients.
  • To assess changes in forearm blood flow (FBF) responses to vasoactive agents before and after candesartan treatment.

Main Methods:

  • Intrabrachial infusions of N(G)-monomethyl-L-arginine (L-NMMA), norepinephrine, TAK 044 (ET A/B antagonist), sodium nitroprusside, and acetylcholine were used.
  • Forearm blood flow (FBF) was measured in 15 hypertensive patients and 15 controls.
  • Hypertensive patients were studied before and after 2 and 12 months of candesartan cilexetil treatment (8-16 mg/day).

Main Results:

  • Hypertensive patients exhibited reduced vasoconstriction to L-NMMA and enhanced vasodilation to TAK-044 compared to controls.
  • Candesartan treatment significantly improved L-NMMA-induced vasoconstriction and enhanced acetylcholine and sodium nitroprusside responses after 12 months.
  • The vasodilation to TAK-044 was abolished after candesartan treatment, correlating with reduced plasma ET-1 levels.

Conclusions:

  • Candesartan, an ARB, improves tonic nitric oxide release in hypertensive patients.
  • Candesartan effectively reduces vasoconstriction mediated by endogenous endothelin-1.
  • The findings support candesartan's role in improving endothelial dysfunction associated with essential hypertension.

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