title: Arterial-cardiac destiffening following long-term antihypertensive treatment.
abstract: BACKGROUND
  We examined whether in addition to producing a greater degree of improvement of the arterial stiffness, long-term angiotensin II receptor blocker (ARB) treatment might also have a more beneficial effect on the cardiac diastolic dysfunction than long-term calcium-channel blocker (CCB) treatment; we also evaluated the association between the improvements of the two variables brought about by ARB treatment in subjects with stage I or II hypertension.
  
  
  METHODS
  One hundred and thirteen patients were randomly allocated to treatment with an ARB (candesartan) or a CCB (amlodipine). Echocardiography and measurement of the brachial-ankle pulse wave velocity (PWV) were conducted in both groups at the start of the treatment and at the end of 2-3-years' treatment.
  
  
  RESULTS
  After adjustments for covariates, the extent of reduction of the brachial-ankle PWV (-200 ± 18 cm/s vs. -141 ± 18 cm/s, P = 0.03) and that of the increase of the E/A ratio (0.08 ± 0.03 vs. 0.01 ± 0.03, P = 0.04) were significantly greater in the candesartan group than in the amlodipine group. A significant relationship was identified between the delta changes of the brachial-ankle PWV and delta changes of the E/A ratio observed following long-term candesartan treatment.
  
  
  CONCLUSIONS
  Long-term candesartan treatment may have a more beneficial effect on the stiffness of the large- to- middle-sized arteries than long-term amlodipine treatment, and this treatment may also concomitantly improve the cardiac diastolic dysfunction; a significant association appeared to exist between the improvements of the two variables observed following long-term candesartan treatment.
authors.affiliation: Second Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan. (tomiyama@tokyo-med.ac.jp
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tomiyama
authors.forename: Masanobu
authors.initials: M
authors.lastname: Yoshida
authors.forename: Jiko
authors.initials: J
authors.lastname: Yamada
authors.forename: Chisa
authors.initials: C
authors.lastname: Matsumoto
authors.forename: Mari
authors.initials: M
authors.lastname: Odaira
authors.forename: Kazuki
authors.initials: K
authors.lastname: Shiina
authors.forename: Akira
authors.initials: A
authors.lastname: Yamashina
mesh_terms: D000368:Aged; D017311:Amlodipine / Q000494:pharmacology; D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology*; D055109:Ankle Brachial Index; D000959:Antihypertensive Agents / Q000494:pharmacology*; D001562:Benzimidazoles / Q000494:pharmacology; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers / Q000494:pharmacology; D003971:Diastole / Q000187:drug effects; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D013777:Tetrazoles / Q000494:pharmacology; D059289:Vascular Stiffness / Q000187:drug effects*
chemical_list: D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D002121:Calcium Channel Blockers; D013777:Tetrazoles; D017311:Amlodipine; C081643:candesartan