Clinical effects of calcium channel blocker and Angiotensin converting enzyme inhibitor on endothelial function and arterial stiffness in patients with angina pectoris

J Korean Med Sci. 2009 Apr;24(2):223-31. doi: 10.3346/jkms.2009.24.2.223. Epub 2009 Apr 20.

Abstract

To evaluate the effects of calcium channel blocker (CCB) and angiotensin converting enzyme inhibitor (ACEI) on endothelial function and arterial stiffness in stable angina pectoris (SAP), 87 patients with SAP (57.6+/-10.0 yr, 52 males) were divided into two groups; CCB group (group I: n=44, 57.9+/-9.7 yr, 23 males) vs. CCB plus ACEI group (group II: n=43, 57.2+/-10.5 yr, 29 males). Flow mediated vasodilation (FMD) of the brachial artery, pulse wave velocity (PWV), urinary albumin excretion (UAE), and high sensitivity C-reactive protein (hsCRP) were compared. FMD, PWV, UAE, and hsCRP were not different between the groups at baseline. After 6 months of treatment, FMD were significantly improved in group II (7.5+/-3.7 to 8.8+/-2.7%, p<0.001), but not in group I (7.9+/-2.7 to 8.2+/-2.8%, p=0.535). Brachial-ankle PWV were significantly improved in both groups (1,621.3+/-279.4 to 1,512.1+/-225.0 cm/sec in group I, p<0.001, 1,586.8+/-278.5 to 1,434.5+/-200.5 cm/sec in group II, p<0.001). However, heart-femoral PWV were significantly improved (1,025.7+/-145.1 to 946.2+/-112.2 cm/sec, p<0.001) and UAE were significantly decreased (20.19+/-29.92 to 13.03+/-16.42 mg/g Cr, p=0.019) in group II only. In conclusion, combination therapy with CCB and ACEI improves endothelial function, arterial stiffness, and UAE than CCB mono-therapy more effectively in patients with SAP.

Keywords: Angina Pectoris; Arterial Stiffness; Endothelial Function.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Angina Pectoris / drug therapy*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Arteries / physiopathology*
  • Blood Flow Velocity / physiology
  • Brachial Artery / drug effects
  • Brachial Artery / physiopathology
  • Calcium Channel Blockers / therapeutic use*
  • Drug Therapy, Combination
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / physiopathology*
  • Humans
  • Male
  • Middle Aged
  • Vasodilation / drug effects

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Calcium Channel Blockers