Benefits of candesartan on arterial and renal damage of non-diabetic hypertensive patients treated with calcium channel blockers.
OBJECTIVE
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.


CONCLUSIONS
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.
Ichihara
Atsuhiro
A
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Kaneshiro
Yuki
Y
Takemitsu
Tomoko
T
Sakoda
Mariyo
M
Itoh
Hiroshi
H
D000368:Aged; D000419:Albuminuria / Q000503:physiopathology / Q000652:urine; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002339:Carotid Arteries / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D007668:Kidney / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow / Q000187:drug effects; D013777:Tetrazoles / Q000627:therapeutic use*; D017539:Tunica Intima / Q000187:drug effects / Q000503:physiopathology
D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D013777:Tetrazoles; C081643:candesartan