Nifedipine and losartan effects on endothelial function during acute pharmacological test in arterial hypertension patients with various risk factors
Abstract
Aim. To study nifedipine and losartan effects on endothelial function (EF) during acute pharmacological test (APT) in arterial hypertension (AH) patients with several risk factors (RF).
Material and methods. The study included 94 patients with Stage I AH. All participants were divided into three groups: Group I – 31 AH patients with obesity (mean body mass index (BMI) 34,7±3,37 kg/m2); Group II – 32 smokers with AH and mean BMI 23,5±2,19 kg/m2; Group III - 31 AH patients with two RF (smoking and obesity) and mean BMI 35,1±3,72 кг/м2. Mean age was 47,9±8,2 years, mean AH duration - 12,4±2,0 years in Group I, 11,0±1,8 years in Group II, and 11,8±1,7 years in Group III. Angiotensin II receptor antagonist losartan was used as a comparison agent. All participants underwent general clinical examination. Endothelium dependent vasodilatation, diameters of common carotid artery and brachial artery, BA (Duplex method), linear blood flow velocities (peak systolic, maximal end diastolic, time averaged maximal velocities), and peripheral resistance index were measured. The participants received nifedipine (20 mg/d) and losartan (100 mg/d) once.
Results. Comparative analysis of two medications’ effectiveness demonstrated improved endothelium dependent vasodilatation during APT with nifedipine and losartan. After nifedipine APT, BA diameter significantly increased in Groups I and III, after losartan APT – in Group III.
Conclusion. Nifedipine improved EF in AH patients with various RF
About the Authors
M. O. Argunova
Russian Medical Academy of Post-Diploma Education, State Agency for Health and Social Development.
Moscow
Russian Federation
Russian Federation
A. G. Avtandilov
Russian Medical Academy of Post-Diploma Education, State Agency for Health and Social Development.
Moscow
Russian Federation
Russian Federation
References
1. Guidelines Subcommittee of the World Health Organization. International Society of Hypertension Mild Hypertension Liaison Committee. 1999 World Health Organization – International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens 1999; 17: 151-83.
2. Hubert HB, Feinleib M, Mcnamara PM, Castelli WP. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation 1983; 67(5): 968-77.
3. Fuster V, Gotto AM, Libby P, et al. 27th Bethesta Conference: matching the intensity of risk factor management with the hazard for coronary disease events. Task Forse 1. Pathogenesis of coronary disease: the biologic role of risk factors. JACC 1996; 27: 964-76.
4. Арабидзе Г.Г. Симптоматические артериальные гипертонии. Болезни сердца и сосудов: Руководство для врачей: В 4-х т. Т.3. Под ред. Е.И.Чазова. Москва «Медицина» 1992; 196-226.
5. Затейщикова А.А., Затейщиков Д.А. Эндотелиальная регуляция сосудистого тонуса: методы исследования и клиническое значение. Кардиология 1998; 9: 68-80.
6. Burt VL, Whelton P, Roccella EJ, et al. Prevalence of hypertension in the US adult population. Results from the Third National Health and Nutrition Examination Survey, 1988-1991. Hypertension 1995; 25(3): 305-13.
7. Колесова М.А. Прогностическая оценка эффективности гипотензивной терапии по результатам однократных медикаментозных проб. Дисс канд мед наук. Москва 1989.
8. Ольбинская Л.И., Морозова Т.Е. Фармакотерапия гипертонической болезни 2002; 35 с.
9. Celermajer DS, Sorensen KE, Spiegelhalter DJ, et al. Anging is the associated with endothelial dysfunction in healthy men years before the age6related decline in women. JACC 1994; 24: 471-6.
10. Абасова Л.И. Влияние однократного приема каптоприла и коринфара на результаты велоэргометрической пробой у больных со стенокардией напряжения. Кардиология 1985; 7; 85-9.
11. Behringer K, Berta-Piccoli C, Wed man P, et al. Press or factors and cardiovascular press or responsiveness in lean and ovemveight normal or hypertensive subjects. Hypertension 1992; 19: 615-20.
12. Schiffrin EL, Deng LY. Structure and function resistanse arteries of hypertensive patients treated with a b-bloker or a calcium channel antagonist. J Hypertens 1996; 14: 1247-55.
13. O’Rourke MF, Kelly RP. Wave reflection in the systemic circulation and its implications in ventricular function. J Hypertens 1993; 11: 327-37.
14. Taddei S, Virdis A, Ghiadoni L, et al. Nifedipine enhances endothelium-relaxation and inhibits contractions to endothelin1 and phenilephrine in human hypertension (abstract). Circulation 1997; 66(Suppl.l.): 762-3.
15. Hubert H., Feinleib M, McNamara P, et al. Obesity as an independent risk factor for cardiovascular disease: A2- year follow up of participants in the Framingham Hear study. Circulation 1983; 73: 968-77.
16. Resnick L, Militianu D, Cunnings A, et al. Direct magnetic resonance determination of aortic dispensability in essential hypertension, relation to age, abdominal, visceral fat, and in situ intracellular free magnesium. Hypertension 1997; 30: 654-9.
17. Рациональная фармакотерапия сердечно-сосудистых заболеваний. Руководство для практикующих врачей. Москва «Литтерра» 2006; 698-9.
18. Кукес В.Г. Клиническая фармакология. Москва «Гэотар медицина» 1999; 129-30.
Review
For citations:
Argunova M.O., Avtandilov A.G. Nifedipine and losartan effects on endothelial function during acute pharmacological test in arterial hypertension patients with various risk factors. Cardiovascular Therapy and Prevention. 2008;7(1):24-28. (In Russ.)
Views:
4938
Email this article 
