This Article Full Text Full Text (PDF) All Versions of this Article: 37/9/2381    most recent 01.STR.0000236839.69658.c5v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ariff, B. Articles by Thom, S. Search for Related Content PubMed PubMed Citation Articles by Ariff, B. Articles by Thom, S. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB ATENOLOL Medline Plus Health Information High Blood Pressure Related Collections Remodeling Clinical Studies

(Stroke. 2006;37:2381.)
© 2006 American Heart Association, Inc.

Research Reports

Candesartan- and Atenolol-Based Treatments Induce Different Patterns of Carotid Artery and Left Ventricular Remodeling in Hypertension

Ben Ariff, MRCP; Andrew Zambanini, MRCP; Sarita Vamadeva, MBBS, BSc; Dean Barratt, PhD; Yun Xu, PhD; Peter Sever, PhD, FRCP; Alice Stanton, PhD, FRCPI; Alun Hughes, MB, PhD Simon Thom, MD, FRCP

From the Department of Clinical Pharmacology (B.A., A.Z., S.V., D.B., P.S., A.H., S.T.), International Centre for Circulatory Health, National Heart and Lung Division, Faculty of Medicine, Imperial College, London, England; the Department of Chemical Engineering (Y.X.), Imperial College, London, England; and the Department of Molecular and Cellular Therapeutics and the RCSI Research Institute (A.S.), Royal College of Surgeon’s in Ireland, Dublin, Ireland.

Correspondence to Dr Ben Ariff, International Centre for Circulatory Health, St. Mary’s Hospital, 59 N Wharf Road, London W2 1LA, UK. E-mail b.ariff{at}imperial.ac.uk

Background and Purpose— Angiotensin receptor blocker (ARB)–based treatment reduces cardiovascular events and stroke more than does ß-blocker-based treatment despite similar blood pressure (BP) reduction. We investigated whether these treatments have different effects on cardiac and large-artery remodelling and evaluated the relation of arterial remodelling to hemodynamic changes in subjects with hypertension.

Methods— We compared the treatment effects of an ARB (candesartan cilexetil)-based regimen and a ß-blocker (atenolol)–based regimen for 52 weeks on common carotid artery (CCA) and left ventricular structure in hypertensive patients in a randomized, double-blind study. Clinic brachial BP and 24-hour ambulatory BP, carotid BP, left ventricular mass index, CCA intima-media thickness, lumen diameter, intima-media area, and carotid blood flow were measured. Distensibility, circumferential tensile stress, Young’s elastic modulus (E_m), and shear stress () in the CCA were also calculated.

Results— Both candesartan and atenolol reduced intima-media thickness and intima-media area and increased distensibility to similar extents after 52 weeks of treatment. Despite similar reductions in BP, treatment with atenolol resulted in a lesser reduction in left ventricular mass index, a decrease in lumen diameter, and a reduction in carotid blood flow compared with candesartan.

Conclusions— BP-independent effects of ARB on cardiac and arterial structure may contribute to the beneficial effects of these agents on cardiovascular disease.

Key Words: antihypertensive agents • hypertension • intima-media thickness

This article has been cited by other articles:

				R. H. Fagard, H. Celis, L. Thijs, and S. Wouters Regression of Left Ventricular Mass by Antihypertensive Treatment: A Meta-Analysis of Randomized Comparative Studies Hypertension, November 1, 2009; 54(5): 1084 - 1091. [Abstract] [Full Text] [PDF]

				S. Thom, C. Stettler, A. Stanton, N. Witt, R. Tapp, N. Chaturvedi, S. Allemann, J. Mayet, P. Sever, N. Poulter, et al. Differential Effects of Antihypertensive Treatment on the Retinal Microcirculation: An Anglo-Scandinavian Cardiac Outcomes Trial Substudy Hypertension, August 1, 2009; 54(2): 405 - 408. [Abstract] [Full Text] [PDF]

				S. Laurent, M. Briet, and P. Boutouyrie Large and Small Artery Cross-Talk and Recent Morbidity-Mortality Trials in Hypertension Hypertension, August 1, 2009; 54(2): 388 - 392. [Full Text] [PDF]

				K. O. Stumpe, E. Agabiti-Rosei, T. Zielinski, D. Schremmer, J. Scholze, P. Laeis, P. Schwandt, and M. Ludwig Original Research: Carotid intima-media thickness and plaque volume changes following 2-year angiotensin II-receptor blockade. The Multicentre Olmesartan atherosclerosis Regression Evaluation (MORE) study Therapeutic Advances in Cardiovascular Disease, December 1, 2007; 1(2): 97 - 106. [Abstract] [PDF]