J Korean Med Sci.  2009 Apr;24(2):223-231. 10.3346/jkms.2009.24.2.223.

Clinical Effects of Calcium Channel Blocker and Angiotensin Converting Enzyme Inhibitor on Endothelial Function and Arterial Stiffness in Patients with Angina Pectoris

• Kim KH
• Jeong MH
• Cho SH
• Moon JY
• Hong YJ
• Park HW
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 1779122
• DOI: http://doi.org/10.3346/jkms.2009.24.2.223

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.

Keyword

Endothelial Function; Arterial Stiffness; Angina Pectoris

MeSH Terms

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

Figure

• 

  Fig. 1 Relation between heart-femoral pulse wave velocity (PWV) and brachial-ankle PWV.

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  Fig. 2 Relation between urinary albumin excretion (UAE) and pulse wave velocity (PWV).

• 

  Fig. 3 Changes of flow-mediated vasodilation (FMD) of the brachial artery after 6 months of medical therapy.

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  Fig. 4 Changes of heart-femoral pulse wave velocity (PWV) after 6 months of medical therapy.

• 

  Fig. 5 Changes of brachial-ankle pulse wave velocity (PWV) after 6 months of medical therapy.

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