Structural-functional properties of the vascular wall in hypertensive patients with coronary heart disease: effects of felodipin and perindopril


Cite item

Full Text

Abstract

Aim. To study endothelial function and vascular elasticity in hypertensive patients with coronary heart disease (CHD) and approaches to correction of the impairments with felodipin and perindopril.
Material and methods. The trial included 34 hypertensive patients with CHD and 17 controls free of cardiovascular diseases. The above cardiovascular patients were randomized into two groups: 15 patients of group 1 received felodipin, 19 patients of group 2 were given perindopril. If the target blood pressure was not achieved after 4 weeks of treatment, 12.5 mg hydrochlorotiazide was added. 24-h monitoring of blood pressure, reactive hyperemia and nitroglycerin tests were made initially and after 8-week treatment. Also, calculations were made of pulse wave velocity (PWV) on the carotid-femoral and carotid-radial segments (Ve and Vm), of elastic modulus for arteries of the elastic and muscular types (Ee and Em).
Results. Baseline endothelium-dependent and non-endothelium-dependent vasodilations (EDVD and NEDVD) in cardiovascular patients were lower than in the controls while Ve and Ee were higher. Systolic blood pressure (SBP), pulse blood pressure (PBP), stress SBP and EDVD correlated. The treatment led to reduction of mean circadian, diurnal and nocturnal SBP, diastolic blood pressure (DBP), PBP, Ve and Ee, to elevation of EDVD.
Conclusion. EDVD in hypertensive patients with CHD is related with SBP and PBP. Felopidin had both an antihypertensive and vasoprotective effects due to improved endothelial function and better elasticity of the major arteries comparable to effects of perindopril.

References

  1. Сидоренко Б. А., Затейщиков Д. А. Дисфункция эндотелия в патогенезе атеросклероза и его осложнений. Кремл. мед. Клин. вестн. 1999; 2: 5-9.
  2. Simon A., Gastro A., Kaski J. C. Assessment of endothelial dysfunction and its clinical usefulness. Rev. Esp. Cardiol. 2001; 54(2): 211-217.
  3. Котовская Ю. В., Кобалава Ж. Д. Анализ пульсовой волны: новая жизнь старого метода. Сердце 2007; 35: 133- 137.
  4. Кочкина М. С., Затейщиков Д. А., Сидоренко Б. А. Измерение жесткости артерий и ее клиническое значение. Кардиология 2005; 1: 63-71.
  5. Celermajer D. S., Sorensen K. E., Gooch V. M. et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340: 1111-1115.
  6. Luscher T. F., Noll G. The pathogenesis of cardiovascular disease: role of the endothelium as a target and mediator. Atherosclerosis 1995; 118: S81-S90.
  7. Hashimoto V., Eto V., Akishita M. et al. Correlation between flow mediated vasodilatation of the brachial artery and intima media thickness in the carotid artery in men. Atheroscler. Thromb. Vasc. Biol. 1999; 19: 2795-2800.
  8. Popele van N. M., Grobbee D. E., Bots M. L. et al. Association between arterial stiffness and atherosclerosis. The Rotterdam Study. Stroke 2001; 32: 454-460.
  9. Карпов Ю. А. Антагонисты кальция в лечении артериальной гипертонии: снижение артериального давления и дополнительные благоприятные эффекты. Рус. мед. журн. 2006; 20(14): 1484-1489.
  10. Марцевич С. Ю. Антагонисты кальция из группы дигидропиринов: данные доказательной медицины и практические рекомендации по использованию. Рационал. фармакотер. в кардиол. 2007; 1: 55-59.
  11. Добровольский А. В. Блокаторы кальциевых каналов - производные дигидропиридина в терапии заболеваний сердечно-сосудистой системы. Рус. мед. журн. 2005; 27(13): 1850-1858.
  12. Giugliano D., Harfella R., Acamporo R. et al. Effects of perindopril and carvedilol on endothelium-dependent vascular functions in patients with diabetes and hypertension. Diabet. Care 1998; 21(4): 402-409.
  13. Ferrari R. Angiotensin converting enzyme inhibition in cardiovascular disease: evidence with perindopril. Exp. Rev. Cardiovasc. Ther. 2005; 3: 15-29.
  14. Louis W. J., Conway E. L., Krum H. et al. Comparison of the pharmacokinetics and pharmacodynamics of perindopril, cilazapril and enalapril. Clin. Exp. Pharmacol. Physiol. 1992; 19: 55-60.
  15. Ghiadoni L., Magagna A., Versari D. et al. Different effect of antihypertensive drugs on conduit artery endothelial function. Hypertension 2003; 94: 3115-3122.
  16. Asmar R., Topouchian J., Pannier B. et al. Pulse wave velocity as endpoint lage scale intervention tial. The Complior study. Scientific, quality control, coordination and investigation committees of the Complior study. J. Hypertens. 2001; 19: 813- 818.
  17. Vogel R. A. Coronary risk factors, endothelial function and atherosclerosis: a review. Clin. Cardiol. 1997; 20: 426-432.
  18. Nabel E. G., Selwyn A. P., Ganz P. et al. Large coronary arteries in humans are responsive to changing blood flow: an endotheliumdependent mechanism that fails in patients with atherosclerosis. J. Am. Coll. Cardiol. 1990; 16(2): 349-356.
  19. Yeung A. C., Vekshtein V. L., Krantz D. S. et al. The effect of atherosclerosis on the vasomotor response of coronary arteries to mental stress. N. Engl. J. Med. 1991; 325(22: 1551-1556.
  20. Затейщикова А. А., Затейщиков Д. А. Эндотелиальная регуляция сосудистого тонуса: методы исследования и клиническое значение. Кардиология 1998; 9: 68-80.
  21. Mombouli J. V. ACE inhibition, endothelial function and coronary artery lesions. Role of kinins and nitric oxide. Drugs 1997; 54(5): 12-22.
  22. Luscher T. F. Endothelial dysfunction: the role and impact of the renin-angiotensin system. Heart 2000; 84(1): 20-22.
  23. Mancini G., Henry G., Mancaya C. et al. Angiotensin-converting enzyme inhibition with quinapril improves endothelial vasomotor dysfunction in patients with coronary disease. Circulation 1996; 94: 258-265.
  24. The EUROPA investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet 2003; 362: 782-788.
  25. Chiadoni L. Different effect of antihypertensive drugs on conduit artery endothelial function. Hypertension 2003; 41: 1281-1286.
  26. Auch-Schwelk W., Vanhoutte P. M. Endothelium-derived relaxing factor(s) and calcium antagonists. Z. Kardiol. 1998; 78(6): 120-123.
  27. Кательницкая Л. И., Хаишева Л. А., Кациева А. А. Особенности функции эндотелия у больных ИБС в различных возрастных группах. Южно-рос. мед. журн. 2004; 2: 17- 21.
  28. Илюхин О. В., Калганова Е. Л., Лопатин Ю. М. Стенокардия напряжения и эластические свойства магистральных артерий. Вестн. Волгоградского ГМУ 2005; 2: 53-57.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2009 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies