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KMID : 0648320090150020020
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Journal of The Korean Society of Hypertension
2009 Volume.15 No. 2 p.20 ~ p.31
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Comparison of the Effect of Angiotensin II Receptor Blocker and Calcium Channel Blocker on Arterial Stiffness in Middle Aged Subjects with Essential Hypertension : Using the Changes in Central Aortic Pressure, Carotid Stiffness, Pulse Wave Velocity, and Biomarkers
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Seo Suk-Min
Jung Hae-Ok
Koh Yoon-Seok
Park Chan-Seok
Park Hun-Jun
Oh Yong-Seog
Baek Sang-Hong
Youn Ho-Joong
Chung Wook-Sung
Seung Ki-Bae
Kim Jae-Hyung
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Abstract
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Backgrounds: Arterial stiffness is known to be a risk factor associated with higher cardiovascular mortality. High sensitivity Creactive protein (hs-CRP) and plasminogen-activator inhibitor-1 (PAI-1) are biomarkers associated with aortic stiffness. In contrast, adiponectin has anti-inflammatory and anti-atherogenic effect on arterial wall. We tried to compare the effect of angiotensin II receptor blocker (ARB) and calcium channel blocker (CCB) on the arterial stiffness in patients with essential hypertension.
Methods: We prospectively and randomly assigned ARB (telmisartan, n=14) and CCB (Lacidipine, n=14) to middle aged (40~65 year-old) patients who first diagnosed as essential hypertension. We measured peripheral blood pressure (BP), central aortic pressure, augmentation index, carotid stiffness index β, pulse wave velocity (PWV) and level of biomarkers (hs-CRP, PAI-1 and adiponectin) before and after 6 months medication each other.
Results: There was no difference in baseline characteristic and 2D Doppler echo parameters between two roups. Peripheral BP and central aortic BP were significantly decreased after 6 months treatment in ARB and CCB group. But there was no difference on the changes of peripheral BP and central aortic pressure between two groups. Pulse wave velocity, augmentation pressure, augmentation index, level of hs-CRP and adiponectin were not significantly changed after 6months ARB or CCB treatment. And also there were no differences on the changes of these indices between two groups. ompared with CCB, however, ARB significantly reduced the level of PAI-1 (-1.6±2.72 vs 0.72±2.14 p=0.013) and carotid stiffness index β(-2.3±2.72 vs 1.7±3.16, p=0.008).
Conclusions: The effect of ARB and CCB on the major arterial stiffness indices as well as peripheral and central BP was not different. However, ARB reduced carotid stiffness index βand PAI-1 more than CCB. It suggests that larger and longer prospective studies are needed.
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KEYWORD
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aortic stiffness, biomarkers, hypertension, angiotensin II receptor blocker, calcium channel blocker
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