Olmesartan, But Not Amlodipine, Improves Endothelium-Dependent Coronary Dilation in Hypertensive Patients

Masanao Naya, Takahiro Tsukamoto, Koichi Morita, Chietsugu Katoh, Tomoo Furumoto, Satoshi Fujii, Nagara Tamaki, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

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Abstract

Objectives: We aimed to compare the effects of the angiotensin II receptor blocker (ARB) olmesartan versus the calcium channel blocker (CCB) amlodipine on coronary endothelial dysfunction in patients with hypertension. Background: Angiotensin II receptor blockers are thought to have greater beneficial effects than CCBs on coronary vasomotion by directly blocking action of angiotensin II. Methods: Twenty-six patients with untreated essential hypertension were prospectively assigned to treatment with either olmesartan (27.7 ± 12.4 mg/day, n = 13) or amlodipine (5.6 ± 1.5 mg/day, n = 13) for 12 weeks. Changes of corrected myocardial blood flow (ΔMBF) and coronary vascular resistance (ΔCVR) from rest to cold pressor were measured by using 15O-water and positron emission tomography before and after treatment. Blood biomarkers including lipids, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and superoxide dismutase (SOD) were also measured. Results: Olmesartan and amlodipine reduced blood pressure (BP) to the same extent (-28.7 ± 16.2 mm Hg vs. -26.7 ± 10.8 mm Hg). In the olmesartan group, ΔMBF tended to be greater (-0.15 ± 0.19 ml/g/min vs. 0.03 ± 0.17 ml/g/min, p = 0.09 by 2-way analysis of variance), and ΔCVR was significantly decreased (7.9 ± 23.5 mm Hg/[ml/g/min] vs. -16.6 ± 18.0 mm Hg/[ml/g/min], p < 0.05) after treatment, whereas these parameters did not change in the amlodipine group (ΔMBF: -0.15 ± 0.12 ml/g/min vs. -0.12 ± 0.20 ml/g/min; ΔCVR: 6.5 ± 18.2 mm Hg/[ml/g/min] vs. 4.8 ± 23.4 mm Hg/[ml/g/min]). Serum SOD activity tended to increase (4.74 ± 4.77 U/ml vs. 5.57 ± 4.74 U/ml, p = 0.07 by 2-way analysis of variance) only in the olmesartan group. Conclusions: Olmesartan, but not amlodipine, improved endothelium-dependent coronary dilation in hypertensive patients independent of BP reduction. These beneficial effects on coronary vasomotion might be via an antioxidant property of ARBs.

Original languageEnglish
Pages (from-to)1144-1149
Number of pages6
JournalJournal of the American College of Cardiology
Volume50
Issue number12
DOIs
Publication statusPublished - Sep 18 2007
Externally publishedYes

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Amlodipine
Endothelium
Dilatation
Vascular Resistance
Angiotensin Receptor Antagonists
Superoxide Dismutase
Analysis of Variance
Blood Pressure
Calcium Channel Blockers
Blood Group Antigens
Angiotensin II
Positron-Emission Tomography
C-Reactive Protein
Insulin Resistance
olmesartan
Interleukin-6
Therapeutics
Tumor Necrosis Factor-alpha
Antioxidants
Biomarkers

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Olmesartan, But Not Amlodipine, Improves Endothelium-Dependent Coronary Dilation in Hypertensive Patients. / Naya, Masanao; Tsukamoto, Takahiro; Morita, Koichi; Katoh, Chietsugu; Furumoto, Tomoo; Fujii, Satoshi; Tamaki, Nagara; Tsutsui, Hiroyuki.

In: Journal of the American College of Cardiology, Vol. 50, No. 12, 18.09.2007, p. 1144-1149.

Research output: Contribution to journalArticle

Naya, Masanao ; Tsukamoto, Takahiro ; Morita, Koichi ; Katoh, Chietsugu ; Furumoto, Tomoo ; Fujii, Satoshi ; Tamaki, Nagara ; Tsutsui, Hiroyuki. / Olmesartan, But Not Amlodipine, Improves Endothelium-Dependent Coronary Dilation in Hypertensive Patients. In: Journal of the American College of Cardiology. 2007 ; Vol. 50, No. 12. pp. 1144-1149.
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title = "Olmesartan, But Not Amlodipine, Improves Endothelium-Dependent Coronary Dilation in Hypertensive Patients",
abstract = "Objectives: We aimed to compare the effects of the angiotensin II receptor blocker (ARB) olmesartan versus the calcium channel blocker (CCB) amlodipine on coronary endothelial dysfunction in patients with hypertension. Background: Angiotensin II receptor blockers are thought to have greater beneficial effects than CCBs on coronary vasomotion by directly blocking action of angiotensin II. Methods: Twenty-six patients with untreated essential hypertension were prospectively assigned to treatment with either olmesartan (27.7 ± 12.4 mg/day, n = 13) or amlodipine (5.6 ± 1.5 mg/day, n = 13) for 12 weeks. Changes of corrected myocardial blood flow (ΔMBF) and coronary vascular resistance (ΔCVR) from rest to cold pressor were measured by using 15O-water and positron emission tomography before and after treatment. Blood biomarkers including lipids, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and superoxide dismutase (SOD) were also measured. Results: Olmesartan and amlodipine reduced blood pressure (BP) to the same extent (-28.7 ± 16.2 mm Hg vs. -26.7 ± 10.8 mm Hg). In the olmesartan group, ΔMBF tended to be greater (-0.15 ± 0.19 ml/g/min vs. 0.03 ± 0.17 ml/g/min, p = 0.09 by 2-way analysis of variance), and ΔCVR was significantly decreased (7.9 ± 23.5 mm Hg/[ml/g/min] vs. -16.6 ± 18.0 mm Hg/[ml/g/min], p < 0.05) after treatment, whereas these parameters did not change in the amlodipine group (ΔMBF: -0.15 ± 0.12 ml/g/min vs. -0.12 ± 0.20 ml/g/min; ΔCVR: 6.5 ± 18.2 mm Hg/[ml/g/min] vs. 4.8 ± 23.4 mm Hg/[ml/g/min]). Serum SOD activity tended to increase (4.74 ± 4.77 U/ml vs. 5.57 ± 4.74 U/ml, p = 0.07 by 2-way analysis of variance) only in the olmesartan group. Conclusions: Olmesartan, but not amlodipine, improved endothelium-dependent coronary dilation in hypertensive patients independent of BP reduction. These beneficial effects on coronary vasomotion might be via an antioxidant property of ARBs.",
author = "Masanao Naya and Takahiro Tsukamoto and Koichi Morita and Chietsugu Katoh and Tomoo Furumoto and Satoshi Fujii and Nagara Tamaki and Hiroyuki Tsutsui",
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T1 - Olmesartan, But Not Amlodipine, Improves Endothelium-Dependent Coronary Dilation in Hypertensive Patients

AU - Naya, Masanao

AU - Tsukamoto, Takahiro

AU - Morita, Koichi

AU - Katoh, Chietsugu

AU - Furumoto, Tomoo

AU - Fujii, Satoshi

AU - Tamaki, Nagara

AU - Tsutsui, Hiroyuki

PY - 2007/9/18

Y1 - 2007/9/18

N2 - Objectives: We aimed to compare the effects of the angiotensin II receptor blocker (ARB) olmesartan versus the calcium channel blocker (CCB) amlodipine on coronary endothelial dysfunction in patients with hypertension. Background: Angiotensin II receptor blockers are thought to have greater beneficial effects than CCBs on coronary vasomotion by directly blocking action of angiotensin II. Methods: Twenty-six patients with untreated essential hypertension were prospectively assigned to treatment with either olmesartan (27.7 ± 12.4 mg/day, n = 13) or amlodipine (5.6 ± 1.5 mg/day, n = 13) for 12 weeks. Changes of corrected myocardial blood flow (ΔMBF) and coronary vascular resistance (ΔCVR) from rest to cold pressor were measured by using 15O-water and positron emission tomography before and after treatment. Blood biomarkers including lipids, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and superoxide dismutase (SOD) were also measured. Results: Olmesartan and amlodipine reduced blood pressure (BP) to the same extent (-28.7 ± 16.2 mm Hg vs. -26.7 ± 10.8 mm Hg). In the olmesartan group, ΔMBF tended to be greater (-0.15 ± 0.19 ml/g/min vs. 0.03 ± 0.17 ml/g/min, p = 0.09 by 2-way analysis of variance), and ΔCVR was significantly decreased (7.9 ± 23.5 mm Hg/[ml/g/min] vs. -16.6 ± 18.0 mm Hg/[ml/g/min], p < 0.05) after treatment, whereas these parameters did not change in the amlodipine group (ΔMBF: -0.15 ± 0.12 ml/g/min vs. -0.12 ± 0.20 ml/g/min; ΔCVR: 6.5 ± 18.2 mm Hg/[ml/g/min] vs. 4.8 ± 23.4 mm Hg/[ml/g/min]). Serum SOD activity tended to increase (4.74 ± 4.77 U/ml vs. 5.57 ± 4.74 U/ml, p = 0.07 by 2-way analysis of variance) only in the olmesartan group. Conclusions: Olmesartan, but not amlodipine, improved endothelium-dependent coronary dilation in hypertensive patients independent of BP reduction. These beneficial effects on coronary vasomotion might be via an antioxidant property of ARBs.

AB - Objectives: We aimed to compare the effects of the angiotensin II receptor blocker (ARB) olmesartan versus the calcium channel blocker (CCB) amlodipine on coronary endothelial dysfunction in patients with hypertension. Background: Angiotensin II receptor blockers are thought to have greater beneficial effects than CCBs on coronary vasomotion by directly blocking action of angiotensin II. Methods: Twenty-six patients with untreated essential hypertension were prospectively assigned to treatment with either olmesartan (27.7 ± 12.4 mg/day, n = 13) or amlodipine (5.6 ± 1.5 mg/day, n = 13) for 12 weeks. Changes of corrected myocardial blood flow (ΔMBF) and coronary vascular resistance (ΔCVR) from rest to cold pressor were measured by using 15O-water and positron emission tomography before and after treatment. Blood biomarkers including lipids, glucose, insulin, high-sensitivity C-reactive protein, interleukin-6, tumor necrosis factor-alpha, and superoxide dismutase (SOD) were also measured. Results: Olmesartan and amlodipine reduced blood pressure (BP) to the same extent (-28.7 ± 16.2 mm Hg vs. -26.7 ± 10.8 mm Hg). In the olmesartan group, ΔMBF tended to be greater (-0.15 ± 0.19 ml/g/min vs. 0.03 ± 0.17 ml/g/min, p = 0.09 by 2-way analysis of variance), and ΔCVR was significantly decreased (7.9 ± 23.5 mm Hg/[ml/g/min] vs. -16.6 ± 18.0 mm Hg/[ml/g/min], p < 0.05) after treatment, whereas these parameters did not change in the amlodipine group (ΔMBF: -0.15 ± 0.12 ml/g/min vs. -0.12 ± 0.20 ml/g/min; ΔCVR: 6.5 ± 18.2 mm Hg/[ml/g/min] vs. 4.8 ± 23.4 mm Hg/[ml/g/min]). Serum SOD activity tended to increase (4.74 ± 4.77 U/ml vs. 5.57 ± 4.74 U/ml, p = 0.07 by 2-way analysis of variance) only in the olmesartan group. Conclusions: Olmesartan, but not amlodipine, improved endothelium-dependent coronary dilation in hypertensive patients independent of BP reduction. These beneficial effects on coronary vasomotion might be via an antioxidant property of ARBs.

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