Comparison of endothelial function in patients with Stage I-II arterial hypertension and stable angina, receiving various bradycardic agents and perindopril

Aim. To compare endothelial function in patients with Stage I-II arterial hypertension (AH) and Functional Class (FC) II stable angina, receiving either beta-adrenoblocker (metoprolol tartrate) or If channel inhibitor (ivabradine), combined with perindopril.

Material and methods. In total, 77 patients and 26 healthy volunteers were examined. The patients received either perindopril and metoprolol, or perindopril and ivabradine for 24 weeks. At baseline, and after 12 and 24 weeks, endothelial function (EF) was assessed by plasma levels of von Willebrand factor, vWF and brachial artery reactive hyperemia test.

Results. In patients with Stage I-II AH and FC II stable angina, EF disturbances were manifested in reduced vasomotor function and increased vWF levels, comparing to the controls. Both therapeutic combinations improved EF and decreased the levels of EF markers, elevated at baseline. The combination of perindopril and ivabradine demonstrated greater and earlier EF normalization.

Conclusion. The combination of perindopril and ivabradine, as well as perindopril and metoprolol, showed beneficial effects on EF. This beneficial effect was greater and earlier for perindopril and ivabradine combination, which could be due to greater vasoprotection by ivabradine than by metoprolol combined with perindopril.

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