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Am J Hypertens. 2019 Jun 11;32(7):640-648. doi: 10.1093/ajh/hpz061.

Relationships Between Calcium Channel Blockers and Vascular Function Tests.

Author information

1
Department of Cardiovascular Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
2
Division of Regeneration and Medicine, Hiroshima University Hospital, Hiroshima, Japan.
3
Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
4
Department of Medicine and Molecular Science, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
5
Department of Stem Cell Biology and Medicine, Graduate School of Biomedical and Sciences, Hiroshima University, Hiroshima, Japan.
6
Department of Rehabilitation, Faculty of General Rehabilitation, Hiroshima International University, Hiroshima, Japan.

Abstract

BACKGROUND:

Differences between the effects of calcium channel blockers (CCBs) and other antihypertensive drugs on vascular function have not been fully investigated. The purpose of this study was to determine the confounding effect of CCBs on vascular function tests.

METHODS:

We measured flow-mediated vasodilation (FMD), nitroglycerine-induced vasodilation (NID), and brachial-ankle pulse wave velocity (baPWV) in 1,134 subjects who underwent health-screening examinations or who visited the outpatient clinic at Hiroshima University Hospital.

RESULTS:

FMD and NID were significantly lower (4.3 ± 3.2% vs. 2.3 ± 2.4% and 14.1 ± 5.8% vs. 10.6 ± 5.3%, P < 0.001, respectively) and baPWV was significantly higher (1,604 ± 412 cm/s vs. 1,715 ± 343 cm/s, P < 0.001) in subjects receiving CCB treatment than in subjects without CCB treatment. Multivariate analyses revealed that CCB treatment was significantly associated with lower FMD (β = -0.151, P < 0.001) and lower NID (β = -0.120, P < 0.001) but not with baPWV (β = 0.017, P = 0.42). Propensity score matching analyses revealed that FMD and NID were significantly lower and baseline brachial artery diameter was significantly larger in subjects receiving CCB monotherapy than in subjects without antihypertensive medication or subjects receiving non-CCB antihypertensive monotherapy.

CONCLUSIONS:

CCB treatment was significantly associated with lower FMD and lower NID, which might be, at least in part, due to larger baseline brachia artery diameter, whereas there was no significant association between CCB treatment and baPWV. FMD and NID may be of no use as prognostic markers of cardiovascular events in individuals who have been receiving CCB treatment.

PUBLIC TRIALS REGISTRY NUMBER:

Trial Number UMIN000003409.

KEYWORDS:

arterial stiffness; blood pressure; brachial-ankle pulse wave velocity; calcium channel blocker; endothelial function; endothelium-independent vasodilation; flow-mediated vasodilation; hypertension; nitroglycerine-induced vasodilation

PMID:
31089726
DOI:
10.1093/ajh/hpz061

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