Comparison of the effects of quinapril and losartan on carotid artery intima-media thickness in patients with mild-to-moderate arterial hypertension.
BACKGROUND
Ultrasonographic evidence of increased carotid intima-media thickness (IMT) is known to be associated with generalized atherosclerosis. Therapeutic blockade of the renin-angiotensin system (RAS) with angiotensin-converting enzyme (ACE) inhibitors reportedly reduces carotid IMT in humans. However, there has been no head-to-head comparison of the effects of ACE inhibitor and angiotensin receptor blocker (ARB), a newer type of RAS inhibitor, on carotid IMT.


METHODS
57 hypertensive patients were randomly assigned to treatment with one of two antihypertensive drugs: ACE inhibitor (quinapril; n = 25, group Q) or ARB (losartan; n = 18, group L).


RESULTS
After 1 year of treatment, a similar decrease in mean blood pressure was observed in all groups. Carotid IMT was decreased significantly in group Q (10% decrease, p < 0.05) but did not change in group L. There were no significant changes in other atherosclerotic factors between these two groups.


CONCLUSIONS
Our findings suggest that the antiatherosclerotic effect of quinapril is more potent than that of losartan in hypertensive patients. This effect appears unrelated to the drug's antihypertensive action or to traditional atherosclerotic factors.
Uchiyama-Tanaka
Yoko
Y
Department of Medicine II, Kansai Medical University, Osaka, Japan.
Mori
Yasukiyo
Y
Kishimoto
Noriko
N
Fukui
Masayoshi
M
Nose
Atsuko
A
Kijima
Yasuaki
Y
Yamahara
Hideki
H
Hasegawa
Takamasa
T
Kosaki
Atsushi
A
Matsubara
Hiroaki
H
Iwasaka
Toshiji
T
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002340:Carotid Artery Diseases / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D019808:Losartan / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D000077583:Quinapril; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage*; D016896:Treatment Outcome; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
D000959:Antihypertensive Agents; D044005:Tetrahydroisoquinolines; D019808:Losartan; D000077583:Quinapril