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Published on: September 17, 2015

Effects of candesartan on cardiac and arterial structure and function in hypertensive subjects

J C Spratt1, D J Webb, A Shiels

  • 1University of Edinburgh, UK. jamesspratt@blueyonder.co.uk

Journal of the Renin-Angiotensin-Aldosterone System : JRAAS
|March 7, 2002
PubMed

Insights

Candesartan treatment significantly reduced left ventricular mass and arterial stiffness in hypertensive patients. The study also showed improvements in left ventricular diastolic function and arterial function, indicating a comprehensive cardiovascular benefit.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Hypertension is a major risk factor for cardiovascular disease, often leading to left ventricular hypertrophy and arterial stiffening.
  • Angiotensin II receptor blockers, such as candesartan, are commonly used to manage hypertension.
  • Understanding the comprehensive effects of candesartan on cardiac and vascular parameters is crucial for optimizing treatment strategies.

Purpose of the Study:

  • To evaluate the impact of candesartan cilexetil on left ventricular mass index (LVMI) and function in hypertensive patients.
  • To assess the drug's effects on arterial structure and function, including augmentation index (AIx) and vascular resistance.
  • To determine the blood pressure-lowering efficacy of candesartan using both office and ambulatory monitoring.

Main Methods:

  • A 24-week study involving 35 hypertensive patients treated with candesartan (16 mg daily), with optional hydrochlorothiazide addition.
  • Left ventricular structure and function were assessed via transthoracic echocardiography.
  • Arterial function was measured using pulse wave analysis and forearm plethysmography; blood pressure was monitored via office readings and 24-hour ambulatory BP monitoring (ABPM).

Main Results:

  • Candesartan treatment resulted in a significant mean reduction in LVMI of 4.4 g/m2 (p=0.022).
  • Significant improvements were observed in left ventricular diastolic function, with increased diastolic time and peak filling velocity.
  • Arterial stiffness (AIx) and vascular resistance significantly decreased, alongside substantial reductions in both central and peripheral blood pressure.

Conclusions:

  • 24-week treatment with candesartan (16 mg daily), with or without hydrochlorothiazide, effectively reduced left ventricular mass and arterial hypertrophy in hypertensive patients.
  • The study demonstrated parallel improvements in left ventricular diastolic function and arterial function, highlighting candesartan's multifaceted cardiovascular benefits.
  • Candesartan is an effective therapeutic option for improving cardiac remodeling and vascular health in individuals with hypertension.
Abstract

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