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Three-Month Effects of Candesartan Cilexetil, an Angiotensin II Type 1 (AT1) Receptor Antagonist, on Left Ventricular Mass and Hemodynamics in Patients with Essential Hypertension

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Abstract

Using cine magnetic resonance imaging (MRI) and echocardiography, we investigated the effects of candesartan cilexetil, a specific angiotensin II type 1 (AT1) receptor antagonist, on left ventricular (LV) mass and hemodynamics in patients with essential hypertension. Ten patients (four men and six women) with essential hypertension received candesartan cilexetil 2–8 mg/day orally for 8–12 weeks. After drug administration, systolic blood pressure (BP) decreased from 178.9 ± 17.2 mmHg (mean ± SD) to 150.2 ± 14.3 mmHg (P < 0.0001) and diastolic BP from 101.4 ± 6.5 mmHg to 87.8 ± 11.9 mmHg (P = 0.0021). Both MRI and echocardiography revealed a significant decrease in LV mass index (LVMI) after candesartan cilexetil. MRI indicated that LVMI decreased from 111.3 ± 31.3 g/m2 to 102.6 ± 32.1 g/m2 (P = 0.0484) and echocardiography that LVMI decreased from 123.9 ± 31.1 g/m2 to 115.8 ± 31.4 g/m2 (P = 0.0316). Total systemic vascular resistance decreased significantly during treatment with candesartan cilexetil in both MRI and echocardiography assessment, from 1847.2 ± 636.3 dynes·s·cm−5 to 1540.4 ± 432.0 dynes·s·cm−5 (P = 0.0034) on MRI and from 1820.4 ± 318.8 dynes·s·cm−5 to 1659.0 ± 317.7 dynes·s·cm−5 (P = 0.0060) on echocardiography. These findings suggest that candesartan cilexetil 2–8 mg/day orally for 8–12 weeks is beneficial in the regression of cardiac hypertrophy in patients with essential hypertension.

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References

  1. Kannel WB, Doyle JT, McNamara PM, et al. Precursors of sudden coronary death. Factors related to the incidence of sudden death. Circulation 1975;51:606-613.

    Google Scholar 

  2. McLenachan JM, Henderson E, Morris KI, Dargie HJ. Ventricular arrhythmias in patients with hypertensive left ventricular hypertrophy. N Engl J Med 1987;317:787-792.

    Google Scholar 

  3. Dunn FG, Plingle SD. Left ventricular hypertrophy and myocardial ischemia in systemic hypertension. Am J Cardiol 1987;60:19I-22I.

    Google Scholar 

  4. Levy D, Garrison RJ, Savage DD, et al. Prognostic implications of echocardiographically determined left ventricular mass in the Framingham heart study. N Engl J Med 1990;322:1561-1566.

    Google Scholar 

  5. Kannel WB, Castelli WP, McNamara PM, et al. Role of blood pressure in the development of congestive heart failure. N Engl J Med 1972;287:781-787.

    Google Scholar 

  6. Dahlöf B: The importance of the renin-angiotensin system in reversal of left ventricular hypertrophy. J Hypertens 1993;11(Suppl. 3):S29-S35.

    Google Scholar 

  7. Morgan HE, Baker KM. Cardiac hypertrophy. Mechanical, neural, and endocrine dependence. Circulation 1991; 83:13-25.

    Google Scholar 

  8. Himmelmann A, Svensson A, Bergbrant A, Hansson L. Long-term effects of losartan on blood pressure and left ventricular structure in essential hypertension. J Hum Hypertens 1996;10:729-734.

    Google Scholar 

  9. Cheung B. Increased left-ventricular mass after losartan treatment. Lancet 1997;349:1743-1744.

    Google Scholar 

  10. Shibouta Y, Inada Y, Ojima M, et al. Pharmacological profile of a highly potent and long-acting angiotensin II receptor antagonist, 2-ethoxy-1-[[2′-(1H-tetrazol-5-yl)biphenyl-4-yl] methyl]-1H-benzimidazole-7-carboxylic acid (CV-11974), and its prodrug, (±)-1-(cyclohexyloxycarbonyloxy)-ethyl 2-ethoxy-1-[[2′-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]-1H-benzimidazole-7-carboxylate (TCV-116). J Pharmacol Exp Ther 1993;266:114-120.

    Google Scholar 

  11. Yamaoka O, Yabe T, Okada M, et al. Evaluation of left ventricular mass: Comparison of ultrafast computed tomography, magnetic resonance imaging, and contrast left ventriculography. Am Heart J 1993;126:1372-1379.

    Google Scholar 

  12. Sahn DJ, DeMaria A, Kisslo J, et al. Recommendations regarding quantitation in M-mode echocardiography: Results of a survey of echocardiographic measurements. Circulation 1978;58:1072-1083.

    Google Scholar 

  13. Teichholz LE, Kreulen T, Herman MV, Gorlin R. Problems in echocardiographic volume determinations: Echocardiographic-angiographic correlations in the presence or absence of asynergy. Am J Cardiol 1976;37:7-11.

    Google Scholar 

  14. Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of left ventricular hypertrophy: Comparison to necropsy findings. Am J Cardiol 1986;57: 450-458.

    Google Scholar 

  15. Savage DD, Garrison RJ, Kannel WB, et al. The spectrum of left ventricular hypertrophy in a general population sample: The Framingham Study. Circulation 1987;75(Suppl. I):I26-I33.

    Google Scholar 

  16. Tsunoda K, Abe K, Hagino T, et al. Hypotensive effect of losartan, a nonpeptide angiotensin II receptor antagonist, in essential hypertension. Am J Hypertens 1993;6:28-32.

    Google Scholar 

  17. Ogihara T, Higashimori K, Masuo K, Mikami H. Pilot study of a new angiotensin II receptor antagonist, TCV-116: Effects of a single oral dose on blood pressure in patients with essential hypertension. Clin Ther 1993;15:684-691.

    Google Scholar 

  18. Dahlöf B, Pennert K, Hansson L. Reversal of left ventricular hypertrophy in hypertensive patients. A meta-analysis of 109 treatment studies. Am J Hypertens 1992;5:95-110.

    Google Scholar 

  19. Gottdiener JS, Reda DJ, Massie BM, et al. Effect of single-drug therapy on reduction of left ventricular mass in mild to moderate hypertension. Comparison of six antihypertensive agents. Circulation 1997;95:2007-2014.

    Google Scholar 

  20. Neaton JD, Grimm RH Jr., Prineas RJ, et al. Treatment of mild hypertension study. Final results. JAMA 1993; 270:713-724.

    Google Scholar 

  21. Savage DD, Drayer JIM, Henry WL, et al. Echocardiographic assessment of cardiac anatomy and function in hypertensive subjects. Circulation 1979;59:623-632.

    Google Scholar 

  22. Katz J, Milliken MC, Stray-Gundersen J, et al. Estimation of human myocardial mass with MR imaging. Radiology 1988; 169:495-498.

    Google Scholar 

  23. Germain P, Roul G, Kastler B, et al. Inter-study variability in left ventricular mass measurement. Comparison between M-mode echography and MRI. Eur Heart J 1992;13: 1011-1019.

    Google Scholar 

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Mitsunami, K., Inoue, S., Maeda, K. et al. Three-Month Effects of Candesartan Cilexetil, an Angiotensin II Type 1 (AT1) Receptor Antagonist, on Left Ventricular Mass and Hemodynamics in Patients with Essential Hypertension. Cardiovasc Drugs Ther 12, 469–474 (1998). https://doi.org/10.1023/A:1007754100351

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