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Effects of olmesartan and amlodipine on blood pressure, endothelial function, and vascular inflammation

  • ORIGINAL ARTICLE
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Anti-hypertensive drugs can improve vascular endothelial function. However, the mechanism remains to be elucidated.

Objectives

This study sought to investigate mechanisms of anti-hypertensive drugs on improvement of vascular endothelial function in patients with essential hypertension.

Methods

Forty-five patients (mean age 58.5 ± 11.2 years) with uncontrolled essential hypertension were randomly assigned to receive olmesartan, an angiotensin II type 1 receptor blocker (ARB) (N = 23), or amlodipine, a calcium channel blocker (CCB) (N = 22), for 6 months. Endothelial function was evaluated by flow-mediated dilatation (FMD) of the brachial artery. Vascular inflammation was measured by blood-normalized standardized uptake value, known as a target-to-background ratio (TBR) within the carotid arteries using 18F-fluorodeoxyglucose-positron emission tomography combined with computed tomography.

Results

There were no significant differences of baseline clinical data between the ARB and CCB groups. Both anti-hypertensive drugs comparably lowered blood pressure and increased %FMD. TBR values were reduced by olmesartan (P < .001), while blood pressure variability was decreased by amlodipine (P = .004). Changes in %FMD from baseline (Δ%FMD) were inversely associated with ΔTBR in the olmesartan group (r = − .606, P = .003) and with Δsystolic blood pressure variability in the amlodipine group (r = − .434, P = .039).

Conclusion

Our study indicated that olmesartan and amlodipine could improve endothelial function in patients with essential hypertension in different manners, suppression of vascular inflammation, and decrease in blood pressure variability, respectively.

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Abbreviations

NO:

Nitric oxide

FMD:

Flow-mediated dilatation

BP:

Blood pressure

CCB:

Calcium channel blocker

ACE:

Angiotensin-converting enzyme

ARB:

Angiotensin II type 1 receptor blockers

FDG-PET:

18F-fluorodeoxyglucose-positron emission tomography

CT:

Computed tomography

SD:

Standard deviation

HbA1c :

Glycated hemoglobin

hsCRP:

High-sensitivity C-reactive protein

SUV:

Standardized uptake value

TBR:

Target-to-background ratio

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Acknowledgments

We wish to thank Mami Nakayama, Miho Nakao-Kogure, Katsue Shiramizu, Miyuki Nishikata, and Makiko Kiyohiro (Kurume University) for their technical assistance. We also thank radiation technologists at Kurume University Hospital for their excellent technical assistance.

Disclosures

Akihiro Honda, Nobuhiro Tahara, Atsuko Tahara, Munehisa Bekki, Shoko Maeda-Ogata, Yoichi Sugiyama, Sachiyo Igata, Yuri Nishino, Takanori Matsui, Seiji Kurata, Toshi Abe, Sho-ichi Yamagishi, and Yoshihiro Fukumoto have nothing to disclose regarding the current study.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan

    Akihiro Honda MD, PhD, Nobuhiro Tahara MD, PhD, Atsuko Tahara MD, Munehisa Bekki MD, Shoko Maeda-Ogata MD, Yoichi Sugiyama MD, PhD, Sachiyo Igata PhD & Yoshihiro Fukumoto MD, PhD

  2. Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan

    Yuri Nishino BS & Takanori Matsui PhD

  3. Department of Radiology, Kurume University School of Medicine, Kurume, Japan

    Seiji Kurata MD, PhD & Toshi Abe MD, PhD

  4. Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Showa University School of Medicine, Tokyo, Japan

    Sho-ichi Yamagishi MD, PhD

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  1. Akihiro Honda MD, PhD
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Correspondence to Nobuhiro Tahara MD, PhD.

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Honda, A., Tahara, N., Tahara, A. et al. Effects of olmesartan and amlodipine on blood pressure, endothelial function, and vascular inflammation. J. Nucl. Cardiol. 30, 1613–1626 (2023). https://doi.org/10.1007/s12350-023-03200-y

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