Olmesartan, but not amlodipine, improves endothelium-dependent coronary dilation in hypertensive patients
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概要
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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.
- 2007-09-18
著者
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Tsukamoto Takahiro
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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FURUMOTO Tomoo
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
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Morita Koichi
台湾
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Morita Koichi
Department Of Nuclear Medicine Hokkaido University Graduate School Of Medicine
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Morita K
Department Of Nuclear Medicine Hokkaido University Graduate School Of Medicine
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Togashi Hiroko
北海道大学 医学研究科 薬理
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Togashi Hiroko
Department Of Pharmacology Hokkaido University School Of Medicine
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Nakata Tomoaki
Second Department Of Internal Medicine Sapporo Medicine University
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Furumoto Tomoo
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Naya Masanao
Department Of Cardiovascular Medicine Hokkaido University
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Tamaki Nagara
Hokkaido University School Of Medicine Department Of Tracer Kinetics And Department Of Nuclear Medic
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Katoh C
Department Of Health Science Hokkaido University Graduate School Of Medicine
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Togashi Hiroko
Safety Research Institute For Chemical Compounds
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Tsukamoto Takahiro
Department Of Cardiovascular Medicine Hokkaido University Graduate School Of Medicine
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Morita Ken
Section Of Urology Kushiro City General Hospital
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Katoh Chietsugu
Department Of Nuclear Medicine Hokkaido University School Of Medicine
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Tamaki Nagara
Hokkaido University Nuclear Medicine
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Fujii Satoshi
Cardiology Hokkaido University School Of Medicine
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Tamaki Nagara
Department Of Nuclear Medicine Hokkaido University School Of Medicine
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Fujii Satoshi
Department Of Molecular And Cellular Pathobiology And Therapeutics Nagoya City University Graduate School Of Pharmaceutical Sciences
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