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Candesartan cilexetil improves left ventricular function, left ventricular hypertrophy, and endothelial function in
Naoki Isobe1, Koichi Taniguchi, Shigeru Oshima
1Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan. isobe.n@cvc.pref.gunma.jp
Insights
Candesartan improved cardiac function and reduced left ventricular hypertrophy in patients with hypertensive heart disease. These benefits were observed within six months, irrespective of blood pressure control.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension frequently leads to left ventricular (LV) hypertrophy and impaired cardiac/endothelial function.
- Angiotensin II receptor blockers have demonstrated additional benefits in hypertensive patients.
Purpose of the Study:
- To evaluate the effects of candesartan on cardiac and endothelial function in patients with hypertensive heart disease (HHD).
Main Methods:
- Twenty-nine HHD patients received candesartan (8 mg/day).
- Echocardiography, radionuclide ventriculography, and endothelial function measurements were performed pre- and post-treatment.
- Patients were categorized by blood pressure control: poorly controlled (group P, n=6) and well-controlled (group C, n=23).
Main Results:
- In well-controlled BP (group C), LV diastolic and endothelial function improved at 3 months; LV systolic function and hypertrophy improved at 6 months, sustained at 12 months.
- In poorly controlled BP (group P), significant improvements in LV function, hypertrophy, endothelial function, and brain natriuretic peptide were noted at 6 months.
- Candesartan demonstrated significant improvements in LV systolic and diastolic function, LV hypertrophy, and endothelial function within 6 months.
Conclusions:
- Candesartan effectively improves cardiac and endothelial function in hypertensive heart disease patients.
- The beneficial effects of candesartan are evident within six months, independent of blood pressure control status.
Abstract:
Patients with hypertension often develop left ventricular (LV) hypertrophy and deterioration of the cardiac and endothelial functions. Recent clinical trials have shown the added benefits of angiotensin II receptor blockers in hypertensive patients. Twenty-nine patients with hypertensive heart disease (HHD) underwent echocardiography, radionuclide ventriculography and the measurement of endothelial function before and after administration of candesartan (8 mg/day). The subjects were divided into poorly controlled blood pressure (BP) (group P, n=6) and well controlled BP (group C, n=23). Endothelial function was evaluated from flow-dependent dilation, which was calculated as the percent change of the radial artery diameter during reactive hyperemia after upper arm occlusion, measured with a high-resolution ultrasound system. In group C, LV diastolic function and endothelial function were significantly (p<0.05) improved at 3 months after administration, LV systolic function and hypertrophy were significantly (p<0.05) improved after 6 months and these effects were maintained at 12 months. Even in group P, LV function, LV hypertrophy, endothelial function and brain natriuretic peptide were significantly (p<0.05) improved at 6 months after administration. In patients with HHD, candesartan improves LV systolic and diastolic function, LV hypertrophy and endothelial function within 6 months of administration, regardless of the control of BP.