Abstract 2119: Effects of Telmisartan, an Angiotensin II Receptor Blocker, on Vascular Failure in Hypertensive Patients with Chronic Kidney Disease
Background: Hypertension is known as a major risk factor for cardiovascular disease (CVD). Chronic Kidney Disease (CKD) is also reported as an independent risk factor of CVD. These risk factors are associated with “vascular failure”, which is defined as the integration of endothelial dysfunction, smooth muscle dysfunction, metabolic abnormalities of the vessel wall including inflammation, oxidative stress. We evaluated effects of angiotensin II receptor blocker (ARB) on vascular failure in hypertensive patients with CKD.
Methods: Forty untreated hypertensive patients with CKD (stage 2–3) were randomized to receive telmisartan (Telmisartan group, n=20) or amlodipine (Amlodipine group, n=20). Flow-mediated dilatation (FMD) and nitroglycerin-induced dilatation (NID) of brachial artery were measured by using ultrasound system. Pulse wave velocity (PWV) was measured by using oscilometric technique. We also measured high sensitivity C-reactive peptide (hsCRP) and thiobarbituric acid reactive substance (TBARS) as indexes of inflammation and oxidative stress. Measurements were performed at baseline, and then at 6 and 12 months after the treatments.
Results: Blood pressure was significantly decreased in the both groups, and there was no difference between two groups at baseline, 6 and 12 months. FMD was significantly increased, and PWV, hsCRP, and TBARS were significantly decreased in the both groups. However, these improvements were much better in the telmisartan group as compared with the amlodipine group at 6 and 12 months. NID did not change during this study.
Conclusion: Telmisartan, ARB, improves vascular failure in hypertensive patients with CKD.