Document Detail


Effects of long-term lercanidipine or hydrochlorothiazide administration on hypertension-related vascular structural changes.
MedLine Citation:
PMID:  17380844     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Vascular remodelling and hypertrophy represent early therapeutic targets of antihypertensive treatment. The present study was aimed at assessing the effects of 1-year administration of the highly vasoselective calcium-channel blocker lercanidipine (10 mg/day) or the diuretic compound hydrochlorothiazide (25 mg/day) on hypertension-related vascular alterations. The study was also aimed at assessing whether and to what extent: (i) pharmacological regression of vascular hypertrophy is related only to the blood pressure (BP) reduction "per se" or also to the specific ancillary properties of a given drug and (ii) treatment provides restoration of vascular function indicative of normal vascular structure. DESIGN AND METHODS: In 26 untreated patients with mild-to-moderate essential hypertension sphygmomanometric and finger BP, heart rate, forearm and calf blood flow (venous occlusion plethysmography) and corresponding vascular resistance (forearm and calf vascular resistance: FVR and CVR) were assessed before and following 6 and 12 months of either lercanidipine or hydrochlorothiazide administration. Vascular resistance was also evaluated following a local ischaemic stimulus (FVR(min) and CVR(min)) in order to assess the effects of treatment on arteriolar structural alterations. RESULTS: For superimposable BP reductions, lercanidipine caused FVR and CVR to decrease significantly more than hydrochlorothiazide. Similarly, the FVR(min) and CVR(min) reductions induced by lercanidipine were markedly and significantly greater than those caused by hydrochlorothiazide (-46.1% and -40.9% vs -22.5% and -19.9%, p < 0.01 for both). FVR(min), and CVR(min), however, remained higher than those found in 10 age-matched normotensive individuals. CONCLUSIONS: These data provide evidence that, compared to hydrochlorothiazide, lercanidipine favours a greater regression of the vascular structural changes associated with hypertension, probably through its "ancillary" properties. Lercanidipine, however, does not allow restoration of a "normal" vascular structure, thereby suggesting that vascular hypertrophy is only in part a reversible phenomenon.
Authors:
Guido Grassi; Fosca Quarti-Trevano; Francesco Scopelliti; Gino Seravalle; Cesare Cuspidi; Giuseppe Mancia
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Blood pressure     Volume:  15     ISSN:  0803-7051     ISO Abbreviation:  Blood Press.     Publication Date:  2006  
Date Detail:
Created Date:  2007-03-26     Completed Date:  2007-05-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9301454     Medline TA:  Blood Press     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  268-74     Citation Subset:  IM    
Affiliation:
Clinica Medica, Dipartimento di Medicina Clinica, Prevenzione e Biotecnologie Sanitarie, Università Milano-Bicocca, Ospedale San Gerardo, Monza, Milan, Italy. guido.grassi@unimib.it
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MeSH Terms
Descriptor/Qualifier:
Blood Vessels / drug effects*,  pathology
Calcium Channel Blockers / administration & dosage,  pharmacology
Case-Control Studies
Dihydropyridines / administration & dosage,  pharmacology*
Diuretics / administration & dosage,  pharmacology
Female
Follow-Up Studies
Humans
Hydrochlorothiazide / administration & dosage,  pharmacology*
Hypertension / complications,  drug therapy*
Hypertrophy / drug therapy*
Male
Middle Aged
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Dihydropyridines; 0/Diuretics; 100427-26-7/lercanidipine; 58-93-5/Hydrochlorothiazide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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