Benefits of candesartan on arterial and renal damage of non-diabetic hypertensive patients treated with calcium channel blockers
Benefits of candesartan on arterial and renal damage of non-diabetic hypertensive patients treated with calcium channel blockers
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DOI：
10.1159/000096581
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发表时间：
2006-01-01
影响因子：
4.2
通讯作者：
Itoh, Hiroshi
中科院分区：
文献类型：
--
作者：
Ichihara, Atsuhiro;Kaneshiro, Yuki;Itoh, Hiroshi
背景/目的：虽然长期使用钙通道阻滞剂（CCBs）强化血压（BP）控制可以降低高血压患者的动脉僵硬度和肾损害，但经常需要联合使用降压药来维持强化血压控制。本研究旨在检查坎地沙坦对接受CCBs治疗至少12个月的高血压患者的附加益处。方法：对50例接受CCBs治疗的非糖尿病高血压患者在坎地沙坦或安慰剂治疗前后12个月的脉搏波速度（PWV）、尿白蛋白排泄（UAE）、颈动脉内膜-中膜厚度（IMT）和24小时动态血压进行测定。结果：坎地沙坦显著降低临床血压，并有降低动态血压的趋势，但与安慰剂组相似，但夜间血压降低明显增强了坎地沙坦。与安慰剂相比，加用坎地沙坦显著降低PWV和UAE，但坎地沙坦或安慰剂的IMT不变。临床血压或夜间血压的降低并不能改善PWV或UAE。结论：经CCBs治疗12个月后，加用坎地沙坦可有效改善高血压患者的硬化动脉，而不影响其对bp的影响。版权所有(c) 2006 S. Karger AG，巴塞尔
Background/Aim: Although long-term, intensive blood pressure (BP) control with calcium channel blockers (CCBs) reduced arterial stiffness and renal damage of hypertensive patients, combination therapy with antihypertensive drugs is frequently needed to maintain the intensive BP control. The present study was conducted to examine add-on benefits of candesartan therapy on hypertensive patients treated with CCBs for at least 12 months. Methods: Pulse wave velocity (PWV), urinary albumin excretion (UAE), intima-media thickness (IMT) of the carotid arteries, and 24-hour ambulatory BP were determined in 50 non-diabetic hypertensive patients treated with CCBs before and 12 months after the start of therapy with candesartan or placebo. Results: Candesartan significantly decreased clinic BP and tended to decrease ambulatory BP, but the decreases were similar to those in the placebo group except nocturnal BP decrease, which was significantly enhanced by candesartan. Add-on candesartan significantly decreased PWV and UAE compared to placebo, but IMT was unchanged with candesartan or placebo. The decrease in clinic BP or nocturnal BP decrease did not contribute to the improvement of PWV or UAE. Conclusion: Add-on candesartan functionally improved the stiffened arteries of hypertensive patients treated with CCBs by the end of 12 months of treatment independently of its effects on BPs. Copyright (c) 2006 S. Karger AG, Basel