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Published on: August 17, 2011
Relationships Between Calcium Channel Blockers and Vascular Function Tests
Tatsuya Maruhashi1, Masato Kajikawa2, Shinji Kishimoto3
1Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Insights
Calcium channel blockers (CCBs) significantly lower vascular function measures like flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID). These effects may limit the use of FMD and NID as cardiovascular prognostic markers in patients on CCB treatment.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Vascular Biology
Background:
- The impact of calcium channel blockers (CCBs) on vascular function tests compared to other antihypertensives remains under-investigated.
- Vascular function assessments are crucial for cardiovascular risk stratification.
Purpose of the Study:
- To investigate the confounding effects of calcium channel blockers (CCBs) on vascular function tests.
- To determine if CCBs influence the interpretation of flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID).
Main Methods:
- 1,134 subjects underwent measurements of FMD, nitroglycerine-induced vasodilation (NID), and brachial-ankle pulse wave velocity (baPWV).
- Data were collected from health-screening examinations and outpatient clinics.
- Multivariate and propensity score matching analyses were employed to assess CCB effects.
Main Results:
- Subjects on CCB treatment exhibited significantly lower FMD and NID, and higher brachial-ankle pulse wave velocity (baPWV) compared to non-CCB users.
- Multivariate analysis confirmed CCB treatment was associated with reduced FMD and NID, but not baPWV.
- Propensity score matching indicated lower FMD and NID, and larger baseline brachial artery diameter in CCB monotherapy users.
Conclusions:
- CCB treatment is associated with diminished FMD and NID, potentially due to larger baseline brachial artery diameter.
- There was no significant association between CCB treatment and baPWV.
- FMD and NID may not serve as reliable prognostic markers for cardiovascular events in patients taking CCBs.
Background:
Differences between the effects of calcium channel blockers (CCBs) and other antihypertensive drugs on vascular function have not been fully investigated. The purpose of this study was to determine the confounding effect of CCBs on vascular function tests.
Methods:
We measured flow-mediated vasodilation (FMD), nitroglycerine-induced vasodilation (NID), and brachial-ankle pulse wave velocity (baPWV) in 1,134 subjects who underwent health-screening examinations or who visited the outpatient clinic at Hiroshima University Hospital.
Results:
FMD and NID were significantly lower (4.3 ± 3.2% vs. 2.3 ± 2.4% and 14.1 ± 5.8% vs. 10.6 ± 5.3%, P < 0.001, respectively) and baPWV was significantly higher (1,604 ± 412 cm/s vs. 1,715 ± 343 cm/s, P < 0.001) in subjects receiving CCB treatment than in subjects without CCB treatment. Multivariate analyses revealed that CCB treatment was significantly associated with lower FMD (β = -0.151, P < 0.001) and lower NID (β = -0.120, P < 0.001) but not with baPWV (β = 0.017, P = 0.42). Propensity score matching analyses revealed that FMD and NID were significantly lower and baseline brachial artery diameter was significantly larger in subjects receiving CCB monotherapy than in subjects without antihypertensive medication or subjects receiving non-CCB antihypertensive monotherapy.
Conclusions:
CCB treatment was significantly associated with lower FMD and lower NID, which might be, at least in part, due to larger baseline brachia artery diameter, whereas there was no significant association between CCB treatment and baPWV. FMD and NID may be of no use as prognostic markers of cardiovascular events in individuals who have been receiving CCB treatment.
Public Trials Registry Number:
Trial Number UMIN000003409.
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