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Arterial-cardiac destiffening following long-term antihypertensive treatment

Hirofumi Tomiyama1, Masanobu Yoshida, Jiko Yamada

  • 1Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan. (tomiyama@tokyo-med.ac.jp

American Journal of Hypertension
|June 17, 2011
PubMed

Insights

Long-term candesartan treatment significantly improved arterial stiffness and cardiac diastolic function more than amlodipine. This suggests ARB therapy offers dual benefits for hypertensive patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Management

Background:

  • Arterial stiffness and cardiac diastolic dysfunction are key complications of hypertension.
  • Comparing long-term effects of Angiotensin II Receptor Blockers (ARBs) and Calcium-Channel Blockers (CCBs) on these parameters is crucial.

Purpose of the Study:

  • To compare the efficacy of long-term ARB (candesartan) versus CCB (amlodipine) treatment on arterial stiffness and cardiac diastolic dysfunction in hypertensive patients.
  • To investigate the association between improvements in arterial stiffness and cardiac diastolic function with ARB treatment.

Main Methods:

  • A randomized trial involving 113 patients with stage I or II hypertension.
  • Patients received either candesartan (ARB) or amlodipine (CCB) for 2-3 years.
  • Echocardiography and brachial-ankle pulse wave velocity (PWV) measurements were performed at baseline and follow-up.

Main Results:

  • Candesartan significantly reduced PWV more than amlodipine (-200 vs. -141 cm/s, P=0.03).
  • Candesartan led to a greater increase in the E/A ratio, indicating improved diastolic function (0.08 vs. 0.01, P=0.04).
  • A significant correlation was found between PWV reduction and E/A ratio improvement with candesartan.

Conclusions:

  • Long-term candesartan treatment demonstrates superior benefits for arterial stiffness compared to amlodipine.
  • Candesartan may also improve cardiac diastolic dysfunction, with a linked improvement in arterial stiffness.
  • This suggests ARBs like candesartan offer a dual therapeutic advantage in managing hypertension complications.
Abstract

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