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Olmesartan, but not amlodipine, improves endothelium-dependent coronary dilation in hypertensive patients

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Title: Olmesartan, but not amlodipine, improves endothelium-dependent coronary dilation in hypertensive patients
Authors: Naya, Masanao Browse this author
Tsukamoto, Takahiro Browse this author
Morita, Koichi Browse this author
Katoh, Chietsugu Browse this author
Furumoto, Tomoo Browse this author
Fujii, Satoshi Browse this author
Tamaki, Nagara Browse this author
Tsutsui, Hiroyuki Browse this author →KAKEN DB
Keywords: coronary endothelial function
positron emission tomography
Issue Date: 18-Sep-2007
Publisher: Elsevier Inc.
Journal Title: Journal of the American College of Cardiology
Volume: 50
Issue: 12
Start Page: 1144
End Page: 1149
Publisher DOI: 10.1016/j.jacc.2007.06.013
PMID: 17868805
Abstract: Objectives: We aimed to compare the effects of angiotensin II receptor blocker (ARB) olmesartan versus calcium channel blocker (CCB) amlodipine on coronary endothelial dysfunction in patients with hypertension. Background: ARB is thought to have greater beneficial effects on coronary vasomotion via directly blocking action of angiotensin II than CCB. Methods: Twenty-sex patients with untreated essential hypertension were prospectively assigned to the treatment with either olmesartan (27.7±12.4 mg per day, n=13) or amlodipine (5.6±1.5 mg per day, n=13) for 12 weeks. Changes of corrected myocardial blood flow (ΔMBF) and coronary vascular resistance (ΔCVR) from rest to cold pressor were measured by using 15O-water and positron emission tomography before and after treatment. Blood biomarkers including lipids, glucose, insulin, hs-CRP, interleukin-6, tumor necrosis factor-α, and superoxide dismutase (SOD) were also measured. Results: Olmesartan and amlodipine reduced blood pressure (BP) to the same extent (−28.7±16.2 vs. −26.7±10.8 mmHg). In olmesartan group, ΔMBF tended to be greater (−0.15±0.19 vs. 0.03±0.17 ml/g/min, P=0.09 by 2-way ANOVA) and ΔCVR was significantly decreased (7.9±23.5 vs. −16.6±18.0 mmHg/[ml/g/min], P<0.05) after treatment whereas they did not change in amlodipine group (ΔMBF: −0.15±0.12 vs. −0.12±0.20 ml/g/min; ΔCVR: 6.5±18.2 vs. 4.8±23.4 mmHg/[ml/g/min]). Serum SOD activity tended to increase (4.74±4.77 vs. 5.57±4.74 U/ml, P=0.07 by 2-way ANOVA) only in olmesartan group. Conclusions: Olmesartan, but not amlodipine, improved endothelium-dependent coronary dilation in hypertensive patients independently of BP lowering. These beneficial effects on coronary vasomotion might be via an antioxidant property of ARBs.
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 納谷 昌直

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